scholarly journals Long-Term Survival in Locally Advanced KRAS Wild-Type Pancreatic Adenocarcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Marion Alhenc-Gelas ◽  
Romain Cohen ◽  
Pascale Cervera ◽  
Jean-Christophe Vaillant ◽  
Thierry André
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Poor Prognosis ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Infectious Complications ◽  
Wild Type ◽  
Term Survival ◽  
Molecular Approaches

Pancreatic adenocarcinoma remains a cancer associated with a poor prognosis. For locally advanced pancreatic cancer (LAPC), median overall survival is approximately 16 months. Here we report the case of a 52-year-old LAPC patient treated with chemotherapy followed by chemoradiotherapy that was associated with a 14-year complete remission. A peritoneal relapse was then observed and chemotherapy was undergone until the patient died of infectious complications, 17 years after his diagnosis. The tumor was found KRAS, TP53, BRCA1, and BRCA2 wild-type. This KRAS wild-type LAPC-long survivor case report emphasizes the need to develop molecular approaches to predict LAPC patients’ prognosis.

Pancreas resection for unresectable locally advanced pancreatic cancer (LAPC): Resection rate in the era of FOLFIRINOX and GEM+nabPTX.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 317-317
Author(s):  
Shinichiro Takahashi ◽  
Masafumi Ikeda ◽  
Naoto Gotohda ◽  
Yuichiro Kato ◽  
Masaru Konishi
Keyword(s):  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Specific Treatment ◽  
Tumor Vessel ◽  
Resection Rate ◽  
Term Survival ◽  
Radio Therapy ◽  
Prospective Database

317 Background: Resection for unresectable LAPC after down-staging by chemo(radio)therapy sometimes leads to long-term survival in highly selected pts. However, neither the pts who have best possibility for resection nor resection rate according to the specific treatment were elucidated in LAPC. Methods: A retrospective single-institutional study. From a prospective database, 130 pts received any treatment for LAPC from Jan. 2010 to Mar. 2015 were identified. Main criteria for unresectability were tumor contact with superior mesenteric artery, celiac axis or common hepatic artery > 180°, aortic involvement, and unreconstructible portal vein /superior mesenteric vein due to marked invasion. All MDCT findings before and during treatment of 130 pts were reviewed to check the resectability by a surgeon. Conversion rate to resection according to treatment and situation of tumor-vessel contact before treatment were analyzed. Conversion was considered when tumor was down-staged to borderline resectability. Results: Of 130 pts, gemcitabine (GEM) was administered as initial treatment to 75; GEM and erlotinib to 18; modified FOLFIRINOX to 15; S-1 and concurrent radiotherapy (S1/RT) to 12; GEM and nab-paclitaxel (GEM+nabPTX) to 4; and other regimens to 6. Six patients underwent resection after down-staging. Of the 6 pts (4.6%), 4 received S1/RT, and 1 each received GemErlo and FOLFIRINOX. Furthermore, 7 pts (5.4%) seemed to deserve further examination to check resectability because marginal resectability was shown in follow up MDCT during treatment. Resection rates among treatments were not different significantly. On the other hand, unresectability because of single-vessel invasion and the tumor-vessel contact less than 360° at the same time before treatment showed best opportunity for conversion to resection. The 6 resected pts (MST 30m) showed marginal superiority over unresected 124 pts (MST 16m) in survival (p = 0.17). Conclusions: Resection rate of LAPC did not increase significantly even after FOLFIRINOX or GEM+nabPTX treatment. Pts with LAPC due to single tumor-vessel contact less than 360° have best chance of convert to resection after effective treatment.

Prognostic factors and long-term outcomes of resected pancreatic adenocarcinoma: A comparison between two decades.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 318-318
Author(s):  
Pablo Emilio Serrano Aybar ◽  
Peter Tae Wan Kim ◽  
Kenneth Leung ◽  
Sean P. Cleary ◽  
Carol-anne Moulton ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Median Overall Survival ◽  
Tumor Grade ◽  
Recent Decade ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term

318 Background: There have been improvements in short and long-term survival rates for patients with resected pancreatic adenocarcinoma over time The main objective of this study was to evaluate differences in long-term survival in a cohort of patients with resected pancreatic adenocarcinoma. Methods: This is a retrospective cohort study of patients who underwent pancreatic resection for pancreatic adenocarcinoma over 2 decades at a high volume academic centre. Univariate and multivariate analysis using Cox proportional hazards model were performed to evaluate prognostic factors associated with long-term survival. Time trend analyses were performed to evaluate differences between decades. Results: There were 489 patients identified, 179 patients during the early (1991-2000) and 310 during the recent decade (2001-2010). Main differences between early and recent decade were: node-positive disease rate (59% vs. 69%), number of lymph nodes collected (median 7 vs. 17), perioperative mortality (6.7% vs. 1.6%) and percentage of patients receiving adjuvant therapy (33% vs. 68%), respectively. There were no differences in sex distribution, age, margin positivity rate or tumor grade. In the multivariate analysis, node, margin status, tumor grade, adjuvant therapy and decade of resection were independently associated with overall survival for the entire cohort. Patients who received adjuvant therapy had better median overall survival: 17 [95% confidence interval (CI): 14-22] vs. 26 months (95% CI: 24-31). Median overall survival for the early and recent decade were 16 months (95% CI: 14-20) and 27 months (95% CI: 24-30, p<0.001), respectively. Conclusions: Factors associated with improved long-term survival remain comparable over time: low tumor grade, node and margin negative disease. Short and long-term survival for patients with resected pancreatic adenocarcinoma has improved in the recent decade. This is due to decreased perioperative mortality and increase use of adjuvant therapy.

scholarly journals Factors Associated With Long-Term Survival in Gemcitabine-Concurrent Proton Radiotherapy For Non-Metastatic Locally Advanced Pancreatic Cancer: a Single-Center Retrospective Study

2021 ◽  
Author(s):  
Yuta Ogura ◽  
Kazuki Terashima ◽  
Yoshihide Nanno ◽  
SungChul Park ◽  
Masaki Suga ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Median Survival ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Proton Radiotherapy ◽  
Term Survival ◽  
Long Term Survival ◽  
Factors Associated ◽  
Pancreatic Body

Abstract Background: Factors associated with long-term survival in gemcitabine-concurrent proton radiotherapy (GPT) for non-metastatic locally advanced pancreatic cancer (LAPC) remain unclear. This study aimed to determine the factors associated with long-term survival in GPT for non-metastatic LAPC.Methods: The medical records of 123 patients with LAPC treated with GPT between February 2009 and December 2019 at Hyogo Ion Beam Medical Center were retrospectively reviewed to assess the factors associated with long-term survival outcomes.Results: The median survival time of the total cohort treated with GPT was 18.7 months. The 1- and 2-year overall, local progression-free, and progression-free survival rates were 70.4% and 35.7%, 78.2% and 59.0%, and 38.6% and 20.8%, respectively. Multivariate analysis revealed that LAPCs at the pancreatic body-tail and those without anterior peripancreatic invasion were independently associated with longer overall survival (P = 0.040 and P = 0.015, respectively). The median survival times of patients with LAPC at the pancreatic body-tail and those with LAPC without anterior peripancreatic invasion were 24.1 and 28.1 months, respectively. LAPCs at the pancreatic body-tail had a higher volume ratio irradiated over 60 Gy equivalents at gross tumor volume than those at the pancreatic head (P < 0.001). LAPCs with anterior peripancreatic invasion had more peritoneal recurrence within 6 months than those without anterior peripancreatic invasion (P = 0.039).Conclusions: GPT is a promising treatment option for patients with LAPC at the pancreatic body-tail and those with LAPC without anterior peripancreatic invasion.

scholarly journals Modulated Electro-Hyperthermia as Palliative Treatment for Pancreatic Cancer: A Retrospective Observational Study on 106 Patients

2019 ◽  
Vol 18 ◽  
pp. 153473541987850 ◽  
Author(s):  
Giammaria Fiorentini ◽  
Donatella Sarti ◽  
Virginia Casadei ◽  
Carlo Milandri ◽  
Patrizia Dentico ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Partial Response ◽  
Pancreatic Adenocarcinoma ◽  
Stable Disease ◽  
Poor Prognosis ◽  
Median Overall Survival ◽  
Progressive Disease ◽  
Tumor Response ◽  
Advanced Pancreatic Cancer ◽  
Efficacy And Safety

Background: Pancreatic adenocarcinoma has a poor prognosis, resulting in a <10% survival rate at 5 years. Modulated electro-hyperthermia (mEHT) has been increasingly used for pancreatic cancer palliative care and therapy. Objective: To monitor the efficacy and safety of mEHT for the treatment of advanced pancreatic cancer. Methods: We collected data retrospectively on 106 patients affected by stage III-IV pancreatic adenocarcinoma. They were divided into 2 groups: patients who did not receive mEHT (no-mEHT) and patients who were treated with mEHT. We performed mEHT applying a power of 60 to 150 W for 40 to 90 minutes. The mEHT treatment was associated with chemotherapy and/or radiotherapy for 33 (84.6%) patients, whereas 6 (15.4%) patients received mEHT alone. The patients of the no-mEHT group received chemotherapy and/or radiotherapy in 55.2% of cases. Results: Median age of the sample was 65.3 years (range = 31-80 years). After 3 months of therapy, the mEHT group had partial response in 22/34 patients (64.7%), stable disease in 10/34 patients (29.4%), and progressive disease in 2/34 patients (8.3%). The no-mEHT group had partial response in 3/36 patients (8.3%), stable disease in 10/36 patients (27.8%), and progressive disease in 23/36 patients (34.3%). The median overall survival of the mEHT group was 18.0 months (range = 1.5-68.0 months) and 10.9 months (range = 0.4-55.4 months) for the non-mEHT group. Conclusions: mEHT may improve tumor response and survival of pancreatic cancer patients.

Effect of dose-escalation of IMRT for unresectable pancreatic cancer 1 cm away from the luminal mucosa on long-term survival.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 354-354 ◽  
Author(s):  
Christopher H. Crane ◽  
Awalpreet Singh Chanda ◽  
Eugene Jon Koay ◽  
Gauri R. Varadhachary ◽  
Prajnan Das ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Induction Chemotherapy ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Breath Hold ◽  
Tumor Control ◽  
High Dose ◽  
Term Survival ◽  
Long Term Survival

354 Background: The use of chemoradiation (CXRT) for locally advanced pancreatic cancer (LAPC) is controversial. Delivery of high doses of RT capable of leading to local tumor control is challenging. We reviewed outcomes of treatement with dose-escalated IMRT with curative intent. Methods: Of 211 patients treated from 5/2006 to 8/2014 with CXRT for LAPC, 49(23%) had tumors > 1 cm from the luminal organs ere selected for dose-escalated IMRT using integrated boost (SIB) technique, inspiration breath hold, and computed tomographic (CT) image guidance. Fractionation was optimized for coverage of gross tumor (GTV,Table 1). A 2-5mm margin on the GTV, was treated as an SIB within a microscopic dose. Forty-seven (96%) patients received a median of 4.0 months of induction chemotherapy and 45 (92%) received concurrent capecitabine or gemcitabine. Results: Mean GTV coverage was 86% (95% CI 78% to 94%). Median FU was 32 mo. Median OS and 1, 2, 3 and 5 year OS rates were 22.6mo (95% CI 16.4 to 43.9mo), 83%, 49%,38%, and 18% from the date of diagnosis and 17.8mo, 63%, 38%, 33%, and 18% from the start of RT. Degree of GTV coverage and Biological Equivalent Dose (BED) did not appear to affect outcome. Freedom from progression at 3 y were 40.6% (local) and 37.1% (distant). Acute toxicity was uncommon: grade 2 pain, diarrhea, anorexia, nausea or fatigue in 18 (37%), and grade 3 diarrhea in one patient (2%). Four patients (13%) required transfusion for anemia. One patient had a GI bleed possibly related to treatment. Conclusions: Dose-escalated IMRT across a BED range of 70-100Gy for inoperable patients selected with induction chemotherapy appears well tolerated and may improve the likelihood of long term survival. These results are similar to the best outcomes reported for patients after surgical resection. Incomplete high-dose GTV coverage does not appear to be detrimental. A randomized phase II trial is testing IMRT (RTOG 1201, 63Gy/28fx, with stratification by SMAD4 expression). [Table: see text]

scholarly journals Long-Term Survival due to Chemotherapy including Paclitaxel in a Patient with Metastatic Primary Splenic Angiosarcoma

2021 ◽  
pp. 910-918
Author(s):  
Masanori Takehara ◽  
Hiroshi Miyamoto ◽  
Yasuteru Fujino ◽  
Tetsu Tomonari ◽  
Tatsuya Taniguchi ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Median Overall Survival ◽  
Case Reports ◽  
Case Series ◽  
Stage Iv ◽  
Rare Type ◽  
Term Survival ◽  
Splenic Angiosarcoma ◽  
Line Chemotherapy

A primary splenic angiosarcoma is a rare type of soft tissue sarcoma and is associated with an extremely poor prognosis. In this study, we describe the case of a patient who was diagnosed with metastatic primary splenic angiosarcoma and survived for about 2 years. A 62-year-old female was referred to us for the treatment of splenic angiosarcoma with disseminated intravascular coagulation (DIC) and multiple liver and bone metastases. Paclitaxel therapy resulted in recovery from DIC and enabled her to continue sequential treatment through to sixth-line chemotherapy. We reviewed all splenic angiosarcoma case reports which were described as stage IV to date and compared with our case. From these data, we found that the median overall survival was 105 days, and the prognosis of splenic angiosarcoma of stage IV was worse than conventional case series. Splenectomy was performed in more patients than chemotherapy as a treatment. Moreover, various chemotherapeutic regimens were used. These data suggest that administering chemotherapy including paclitaxel to patients with splenic angiosarcoma might improve their prognosis.

scholarly journals Long-term survival in a cat with pancreatic adenocarcinoma treated with surgical resection and toceranib phosphate

2020 ◽  
Vol 6 (1) ◽  
pp. 205511692092491
Author(s):  
Johanna E Todd ◽  
Sandra M Nguyen
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Surgical Resection ◽  
Side Effect ◽  
Poor Prognosis ◽  
Term Survival ◽  
Free Interval ◽  
Case Summary ◽  
First Case ◽  
Uncommon Neoplasm

Case summary Primary pancreatic adenocarcinoma is an uncommon neoplasm seen in cats and often has a poor prognosis. We report a case of an 8-year-old male neutered domestic shorthair cat weighing 5.8 kg diagnosed with pancreatic adenocarcinoma treated with surgical resection and toceranib phosphate, which had a progression-free interval of 1148 days and survived for more than 1436 days. The treatment was well tolerated; however, the cat developed generalised coat hypopigmentation. Relevance and novel information To our knowledge, the cat in our report has the longest progression-free interval and survival time post-surgical resection of pancreatic carcinoma treated with toceranib. Hypopigmentation as a side effect of toceranib has been reported in dogs, but this is the first case reported in cats.

scholarly journals Duration of Reduced CA19-9 Levels Is a Better Prognostic Factor Than Its Rate of Reduction for Unresectable Locally Advanced Pancreatic Cancer

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4224
Author(s):  
Ko Tomishima ◽  
Shigeto Ishii ◽  
Toshio Fujisawa ◽  
Muneo Ikemura ◽  
Hiroto Ota ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Odds Ratio ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Carbohydrate Antigen ◽  
Good Prognosis ◽  
Locally Advanced Pancreatic Cancer ◽  
Term Survival ◽  
Long Term Prognosis

A decrease in carbohydrate antigen (CA) 19-9 levels has been proposed as a prognostic marker for survival and recurrence in patients with pancreatic cancer. We evaluated the association between duration of reduced CA 19-9 levels during 6 months after treatment and long-term survival for 79 patients with unresectable locally advanced pancreatic cancer (LAPC). We calculated the differences between pretreatment and monthly CA19-9 levels. We categorized 71 patients with decreases in CA19-9 levels into three groups based on the duration of these reduced levels (>2, >3, and >4 months). The cut-off level for long-term (more than 2 years) survival was identified as a 44% reduction from the baseline, using a ROC curve. A reduction duration >2 months was not associated with overall survival (p = 0.1), while >3 months was significantly associated with survival (p =.04). In multivariate analysis, a reduction duration >3 months predicted a good long-term prognosis (odds ratio = 5.75; 95% confidence interval = 1.47–22.36; p < 0.01). In patients with unresectable LAPC, the duration of reduced CA19-9 levels for more than 3 months, rather than the rate of reduction in CA19-9 levels, during 6 months after treatment was significantly associated with good prognosis.

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