Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma
Abstract Objective To determine the effect of clinical status (weight variation and performance status [PS]) at diagnosis and during induction treatment on resectability and overall survival (OS) rates in patients with borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC). Method...
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doaj-a5b7c05fe76241b0b2032fe6ad441fc22020-11-25T03:34:21ZengBMCWorld Journal of Surgical Oncology1477-78192019-06-011711710.1186/s12957-019-1637-1Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinomaPauline Duconseil0Jonathan Garnier1Victoria Weets2Jacques Ewald3Ugo Marchese4Marine Gilabert5Laurence Moureau-Zabotto6Flora Poizat7Marc Giovannini8Jean-Robert Delpero9Olivier Turrini10Department of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMDepartment of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMDepartment of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMDepartment of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMDepartment of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMDepartment of Oncology, Institut Paoli-CalmettesDepartment of Radiotherapy, Institut Paoli-CalmettesDepartment of Pathology, Institut Paoli-CalmettesDepartment of Endoscopy, Institut Paoli-CalmettesDepartment of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMDepartment of Surgical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCMAbstract Objective To determine the effect of clinical status (weight variation and performance status [PS]) at diagnosis and during induction treatment on resectability and overall survival (OS) rates in patients with borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC). Methods From 2005 to 2017, 454 consecutive patients were diagnosed with LAPC or BRPC. We evaluated the PS (0–1 or 2–3), body mass index at diagnosis, and weight loss (WL) > 5% at initial staging and after induction treatment and separated continuous weight loss (CWL) from weight stabilization. Results A total of 294 patients (64.8%) presented with WL, and 57 patients (12.6%) presented with a PS of 2–3. At restaging, 60 patients (13.2%) presented with CWL. Independent factors that poorly influenced the OS were a PS of 2–3 at diagnosis (P < .01), CWL at restaging (P < .01), and absence of resection (P < .01). Factors independently impeding resection were LAPC (P < .01), PS > 1 at diagnosis (P < .01), and CWL (P = .01). In total, 142 patients (31.3%) underwent pancreatectomy. Independent factors that poorly influenced the OS in the resected group were PS > 0 at diagnosis (P = .01) and obesity (P < .01). For the 312 unresected cancer patients (68.7%), CWL (P < .01) was identified as an independent factor that poorly influenced the OS. Conclusion Clinical parameters that are easy to measure and monitor are independent factors of poor prognosis. The variation of weight during the induction treatment, more than WL at diagnosis, significantly precluded resection and was an independent factor of shorter OS in unresected patients.http://link.springer.com/article/10.1186/s12957-019-1637-1 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pauline Duconseil Jonathan Garnier Victoria Weets Jacques Ewald Ugo Marchese Marine Gilabert Laurence Moureau-Zabotto Flora Poizat Marc Giovannini Jean-Robert Delpero Olivier Turrini |
spellingShingle |
Pauline Duconseil Jonathan Garnier Victoria Weets Jacques Ewald Ugo Marchese Marine Gilabert Laurence Moureau-Zabotto Flora Poizat Marc Giovannini Jean-Robert Delpero Olivier Turrini Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma World Journal of Surgical Oncology |
author_facet |
Pauline Duconseil Jonathan Garnier Victoria Weets Jacques Ewald Ugo Marchese Marine Gilabert Laurence Moureau-Zabotto Flora Poizat Marc Giovannini Jean-Robert Delpero Olivier Turrini |
author_sort |
Pauline Duconseil |
title |
Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma |
title_short |
Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma |
title_full |
Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma |
title_fullStr |
Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma |
title_full_unstemmed |
Effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma |
title_sort |
effect of clinical status on survival in patients with borderline or locally advanced pancreatic adenocarcinoma |
publisher |
BMC |
series |
World Journal of Surgical Oncology |
issn |
1477-7819 |
publishDate |
2019-06-01 |
description |
Abstract Objective To determine the effect of clinical status (weight variation and performance status [PS]) at diagnosis and during induction treatment on resectability and overall survival (OS) rates in patients with borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC). Methods From 2005 to 2017, 454 consecutive patients were diagnosed with LAPC or BRPC. We evaluated the PS (0–1 or 2–3), body mass index at diagnosis, and weight loss (WL) > 5% at initial staging and after induction treatment and separated continuous weight loss (CWL) from weight stabilization. Results A total of 294 patients (64.8%) presented with WL, and 57 patients (12.6%) presented with a PS of 2–3. At restaging, 60 patients (13.2%) presented with CWL. Independent factors that poorly influenced the OS were a PS of 2–3 at diagnosis (P < .01), CWL at restaging (P < .01), and absence of resection (P < .01). Factors independently impeding resection were LAPC (P < .01), PS > 1 at diagnosis (P < .01), and CWL (P = .01). In total, 142 patients (31.3%) underwent pancreatectomy. Independent factors that poorly influenced the OS in the resected group were PS > 0 at diagnosis (P = .01) and obesity (P < .01). For the 312 unresected cancer patients (68.7%), CWL (P < .01) was identified as an independent factor that poorly influenced the OS. Conclusion Clinical parameters that are easy to measure and monitor are independent factors of poor prognosis. The variation of weight during the induction treatment, more than WL at diagnosis, significantly precluded resection and was an independent factor of shorter OS in unresected patients. |
url |
http://link.springer.com/article/10.1186/s12957-019-1637-1 |
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