Does long-term survival in patients with pancreatic cancer really exist? Results from the CONKO-001 study

TY - JOUR

T1 - Does long-term survival in patients with pancreatic cancer really exist? Results from the CONKO-001 study

AU - Sinn, Marianne

AU - Striefler, Jana K

AU - Sinn, Bruno V

AU - Sallmon, Daniel

AU - Bischoff, Sven

AU - Stieler, Jens M

AU - Pelzer, Uwe

AU - Bahra, Marcus

AU - Neuhaus, Peter

AU - Dörken, Bernd

AU - Denkert, Carsten

AU - Riess, Hanno

AU - Oettle, Helmut

N1 - © 2013 Wiley Periodicals, Inc.

PY - 2013/11

Y1 - 2013/11

N2 - BACKGROUND: Long-term survival (LTS) in patients (pts) with pancreatic cancer is still uncommon, little data is available to identify long-term survivors. The CONKO-001 study, which established gemcitabine after resection as adjuvant therapy, may provide data to answer this question.METHODS: CONKO-001 pts with an overall survival ≥5 years were compared to those who survived <5 years. Central re-evaluation of primary histology was performed. Univariate analysis with the χ(2) -test identified qualifying factors. Logistic regression was used to investigate the influence of these covariates on LTS.RESULTS: Of the evaluable 354 CONKO-001 pts, 54 (15%) with an overall survival ≥5 years were identified. It was possible to obtain tumor specimens of 39 pts (72%). Histological re-evaluation confirmed adenocarcinoma in 38 pts, 1 showed a high-grade neuroendocrine tumor. Univariate analysis for all 53 LTS pts with adenocarcinoma compared to the remaining 300 non-LTS pts revealed as relevant active treatment, tumor grading, tumor size, lymph nodes. No significance could be demonstrated for resection margin, sex, age, Karnofsky performance status, CA 19-9 at study entry. In multivariate analysis, tumor grading, active treatment, tumor size, lymph node involvement were independent prognostic factors for LTS.CONCLUSION: Long-term survival can be achieved in adenocarcinoma of the pancreas.

AB - BACKGROUND: Long-term survival (LTS) in patients (pts) with pancreatic cancer is still uncommon, little data is available to identify long-term survivors. The CONKO-001 study, which established gemcitabine after resection as adjuvant therapy, may provide data to answer this question.METHODS: CONKO-001 pts with an overall survival ≥5 years were compared to those who survived <5 years. Central re-evaluation of primary histology was performed. Univariate analysis with the χ(2) -test identified qualifying factors. Logistic regression was used to investigate the influence of these covariates on LTS.RESULTS: Of the evaluable 354 CONKO-001 pts, 54 (15%) with an overall survival ≥5 years were identified. It was possible to obtain tumor specimens of 39 pts (72%). Histological re-evaluation confirmed adenocarcinoma in 38 pts, 1 showed a high-grade neuroendocrine tumor. Univariate analysis for all 53 LTS pts with adenocarcinoma compared to the remaining 300 non-LTS pts revealed as relevant active treatment, tumor grading, tumor size, lymph nodes. No significance could be demonstrated for resection margin, sex, age, Karnofsky performance status, CA 19-9 at study entry. In multivariate analysis, tumor grading, active treatment, tumor size, lymph node involvement were independent prognostic factors for LTS.CONCLUSION: Long-term survival can be achieved in adenocarcinoma of the pancreas.

KW - Adenocarcinoma/drug therapy

KW - Aged

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Chemotherapy, Adjuvant

KW - Deoxycytidine/administration & dosage

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Kaplan-Meier Estimate

KW - Logistic Models

KW - Lymphatic Metastasis

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Neoplasm Grading

KW - Neoplasm Staging

KW - Pancreatic Neoplasms/drug therapy

KW - Prognosis

KW - Risk Factors

KW - Time Factors

U2 - 10.1002/jso.23409

DO - 10.1002/jso.23409

M3 - SCORING: Journal article

C2 - 24038103

VL - 108

SP - 398

EP - 402

JO - J SURG ONCOL

JF - J SURG ONCOL

SN - 0022-4790

IS - 6

ER -