scholarly journals Sarcopenia represents a negative prognostic factor in pancreatic cancer patients undergoing EUS celiac plexus neurolysis

2020 ◽  
Vol 9 (4) ◽  
pp. 238 ◽  
Author(s):  
Antonio Facciorusso ◽  
Matteo Antonino ◽  
Nicola Muscatiello
Keyword(s):  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Celiac Plexus ◽  
Negative Prognostic Factor

A retrospective analysis of early CA19-9 progression in salvage-chemotherapy for refractory pancreatic cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15146-e15146
Author(s):  
Yousuke Nakai ◽  
Hiroyuki Isayama ◽  
Takashi Sasaki ◽  
Naminatsu Takahara ◽  
Hirofumi Kogure ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Multivariate Analyses ◽  
Disease Status ◽  
Response Assessment ◽  
Early Response ◽  
Salvage Chemotherapy ◽  
Serum Markers ◽  
Rank Test ◽  
Negative Prognostic Factor

e15146 Background: Early response assessment is important to differentiate patients (pts) who will benefit from salvage chemotherapy (sCx) for refractory pancreatic cancer (PaC), given its palliative nature. CA19-9 has been reported as a prognostic factor in the first-line treatment, but little data is available in sCx. Methods: Pts receiving sCx for refractory PaC at the University of Tokyo Hospital were retrospectively studied. Serum CA19-9 was measured prior to the initiation of each course. Cumulative progression-free (PFS) and overall survival (OS) were calculated by Kaplan-Meier analysis and compared by log-rank test. Prognostic value of CA19-9 change prior to 2nd course was evaluated using a landmark method. Finally, multivariate analyses by the Cox proportional hazard model were performed for PFS and OS. Possible prognostic factors were age, gender, PS, disease status, metastatic site, pretreatment albumin, LDH, CRP, CA19-9, CA19-9 change prior to 2nd course, prior PFS, treatment line (2ndline or beyond) and sCx agents. Results: A total of 167 pts (a median age of 65, 95 males, 21 recurrent and a median previous PFS of 5.8 Mo) received 239 regimens as sCx including S-1(n=87), CPT-11 (n=53), GEM+oxaliplatin(Ox) (n=20), S-1+Ox(n=29), GEM (n=14) and S-1+paclitaxel iv+ip (n=12). Median PFS and OS were 2.7 (95%CI, 2.4-3.1) and 6.1 (95%CI, 5.3-7.2) Mo, respectively. Early CA19-9 progression was defined as CA19-9 increase >17.8%, a median value of CA19-9 change prior to 2nd course in this study population. Median PFS and OS were 2.6 vs. 1.0 Mo and 7.5 vs. 3.6 Mo (p<0.001) after landmark CA19-9 measurement in pts with and without CA19-9 response. Multivariate analyses demonstrated early CA19-9 progression was a negative prognostic factor of both PFS and OS (HR 1.75 and 2.04, p<0.001). Pretreatment serum markers (albumin, LDH, CRP and CA19-9) were prognostic of OS, but not PFS. Conclusions: Early CA19-9 progression was a negative prognostic factor of both PFS and OS in S-Cx for refractory PaC. Early termination should be considered in these patients who would less likely benefit from sCx.

Celiac plexus radiosurgery for pain management in advanced cancer patients: An international phase II trial.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. TPS466-TPS466
Author(s):  
Yaacov Richard Lawrence ◽  
Tikva Meron ◽  
Adam P. Dicker ◽  
Camilla Zimmermann ◽  
Maoz Ben-Ayun ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Clinical Trial ◽  
Cancer Patients ◽  
Short Form ◽  
Pilot Trial ◽  
Celiac Plexus ◽  
High Dose ◽  
Analgesic Use

TPS466 Background: Many cancer patients, especially those with pancreatic cancer, suffer from severe back/epigastric pain. Contemporary approaches (opioids, celiac blocks, systemic chemotherapy) are often inadequate. This clinical trial investigates a new approach in which high-dose radiation (radiosurgery) is focused on the retroperitoneal celiac plexus nerve bundle. Preliminary results from a single institution pilot trial NCT02356406 are promising: pain relief is substantial and side effects minimal. The main aim of the trial is to establish safety/efficacy in the setting of an international multicenter study. Exploratory analyses will examine the relationship between pain reduction and subjects’ quality-of-life, functionality, and caregiver burden. Methods: Eligibility criteria include a diagnosis of metastatic/unresectable malignancy, uncontrolled pain defined as ≥ 5 on 11-point BPI-SF scale despite analgesic use, typical retroperitoneal pain syndrome, prognosis > 8 weeks, ECOG 0-2, anatomical involvement of the celiac plexus (e.g. any pancreatic cancer, or any other cancer involving the celiac trunk). Exclusion criteria include previous upper abdo. radiation. The intervention consists of a single 25 Gy radiation fraction delivered to the celiac plexus, using anterolateral aspect of the aorta from the 12th thoracic to 2nd lumbar vertebral body as a surrogate structure. The primary tumour may be irradiated at physicians’ discretion. Dose-painting technique limits dose to organs at risk. Pain intensity will be measured using Brief Pain Inventory Short Form (BPI-SF), and quality of life with FACT-Hep. The primary endpoint is complete or partial pain response, defined as a decrease between the score immediately before treatment and 3 weeks’ post-treatment. A change of two or more on the BPI 11-point pain scale is defined as clinically significant. Secondary endpoints include other BPI pain endpoints, pain at 6 weeks, analgesic use, toxicity (CTCAE v4.03), quality of life and functional measures. Analgesia is not restricted. Expected accrual is 100 subjects over three years. Supported by Gateway for Cancer Research, additional support from Israel Cancer Association. Clinical trial information: NCT03323489.

Pain Mechanisms Involved and Outcome in Advanced Cancer Patients with Possible Indications for Celiac Plexus Block and Superior Hypogastric Plexus Block

2002 ◽  
Vol 88 (3) ◽  
pp. 243-245 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Fabio Fulfaro ◽  
Alessandra Casuccio
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Advanced Cancer Patients ◽  
Pain Mechanisms ◽  
Pelvic Cancer ◽  
Plexus Block ◽  
Prospective Longitudinal

Aims and Background There is controversy about the role of neurolytic sympathetic blocks in advanced cancer, when pain syndromes may assume other characteristics, with a possible involvement of structures other than visceral. The aim of the present study was to assess the pain characteristics and the analgesic response of a consecutive sample of home care patients with pancreatic and pelvic pain, which would have possible indications for a celiac plexus block and a superior hypogastric block, respectively. Methods From January 1999 to December 1999, 400 consecutive advanced cancer patients were surveyed for a prospective longitudinal survey. We considered only patients who had pancreatic cancer or pelvic cancer with pain. Results Thirty-six patients were surveyed: 22 patients had pelvic cancers and 14 had pancreatic cancer. Patients with pelvic cancers showed a longer survival than those with pancreatic cancer (P = 0.019). Patients with pelvic cancers more frequently showed a neuropathic component associated with a visceral or somatic mechanism than patients with pain due to pancreatic cancer (P = 0.019). When the pain mechanism was taken into consideration, patients with pelvic cancers with a neuropathic component showed worse pain relief than patients with pain due to pancreatic cancer (P = 0.040). Conclusions Sympathetic procedures for pain conditions due to pancreatic and pelvic cancers should be intended as adjuvant techniques to reduce the analgesic consumption, and not as a panacea, given that multiple pain mechanisms are often involved because progression of disease is able to change the underlying pain mechanisms. Pancreatic pain seems to maintain visceral characteristics amenable to sympathetic block more than pain due to pelvic cancer.

787 The Presence of Circulating Tumour Cells is a Negative Prognostic Factor in Lung Cancer Patients

2012 ◽  
Vol 48 ◽  
pp. S187-S188
Author(s):  
A. Benedikova ◽  
J. Srovnal ◽  
J. Klein ◽  
P. Skalicky ◽  
M. Szkorupa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Tumour Cells ◽  
Circulating Tumour Cells ◽  
Lung Cancer Patients ◽  
Negative Prognostic Factor
Sign in / Sign up

Export Citation Format

Share Document