Seung-Seob Kim1, Sunyoung Lee1, Hee Seung Lee2, Seungmin Bang2, Mi-Suk Park3. 1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 2. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. radpms@yuhs.ac.
Abstract
PURPOSE: To identify common and unique pre-treatment prognostic factors in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC), treated with chemotherapy (CTx) or concurrent chemoradiotherapy (CRT). METHODS: We enrolled 215 patients with BR/LA PDAC, who were treated with either CTx (n = 82) or CRT (n = 133) as a first-line treatment between 2013 and 2016. Clinical data and CT imaging findings for predicting overall survival (OS) and progression-free survival (PFS) were analyzed using Cox regression analysis. RESULTS: Carbohydrate antigen (CA) 19-9 > 1000 U/mL (hazard ratio [HR] 1.91; p = 0.001) and non-homogeneous enhancement (HR 1.95; p < 0.001) were associated with shorter OS in all study populations. There was no significant difference in median OS (15.3 vs 16.8 months, p = 0.297) and PFS (10.0 vs 11.7 months, p = 0.321) between the CTx and CRT groups. Non-homogeneous enhancement (HR 2.04; p = 0.006) and presence of positive lymph node on CT (HR 2.38; p = 0.036) were associated with poor OS in the CTx group, while CA 19-9 > 1000 U/mL (HR 2.38; p = 0.001) and non-homogeneous enhancement (HR 1.73; p = 0.006) were independent predictors for poor OS in the CRT group. CONCLUSION: Enhancement pattern on CT was a common prognostic factor for patients with PDAC treated with either CTx or CRT. Presence of positive lymph nodes on CT was a poor prognostic factor for the CTx group only, whereas CA 19-9 > 1000 U/mL was a poor prognostic factor for the CRT group only.
PURPOSE: To identify common and unique pre-treatment prognostic factors in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC), treated with chemotherapy (CTx) or concurrent chemoradiotherapy (CRT). METHODS: We enrolled 215 patients with BR/LA PDAC, who were treated with either CTx (n = 82) or CRT (n = 133) as a first-line treatment between 2013 and 2016. Clinical data and CT imaging findings for predicting overall survival (OS) and progression-free survival (PFS) were analyzed using Cox regression analysis. RESULTS:Carbohydrate antigen (CA) 19-9 > 1000 U/mL (hazard ratio [HR] 1.91; p = 0.001) and non-homogeneous enhancement (HR 1.95; p < 0.001) were associated with shorter OS in all study populations. There was no significant difference in median OS (15.3 vs 16.8 months, p = 0.297) and PFS (10.0 vs 11.7 months, p = 0.321) between the CTx and CRT groups. Non-homogeneous enhancement (HR 2.04; p = 0.006) and presence of positive lymph node on CT (HR 2.38; p = 0.036) were associated with poor OS in the CTx group, while CA 19-9 > 1000 U/mL (HR 2.38; p = 0.001) and non-homogeneous enhancement (HR 1.73; p = 0.006) were independent predictors for poor OS in the CRT group. CONCLUSION: Enhancement pattern on CT was a common prognostic factor for patients with PDAC treated with either CTx or CRT. Presence of positive lymph nodes on CT was a poor prognostic factor for the CTx group only, whereas CA 19-9 > 1000 U/mL was a poor prognostic factor for the CRT group only.
Authors: M Ducreux; A Sa Cuhna; C Caramella; A Hollebecque; P Burtin; D Goéré; T Seufferlein; K Haustermans; J L Van Laethem; T Conroy; D Arnold Journal: Ann Oncol Date: 2015-09 Impact factor: 32.976
Authors: Mustafa Suker; Berend R Beumer; Eran Sadot; Lysiane Marthey; Jason E Faris; Eric A Mellon; Bassel F El-Rayes; Andrea Wang-Gillam; Jill Lacy; Peter J Hosein; Sing Yu Moorcraft; Thierry Conroy; Florian Hohla; Peter Allen; Julien Taieb; Theodore S Hong; Ravi Shridhar; Ian Chau; Casper H van Eijck; Bas Groot Koerkamp Journal: Lancet Oncol Date: 2016-05-06 Impact factor: 41.316
Authors: Edward P Balaban; Pamela B Mangu; Alok A Khorana; Manish A Shah; Somnath Mukherjee; Christopher H Crane; Milind M Javle; Jennifer R Eads; Peter Allen; Andrew H Ko; Anitra Engebretson; Joseph M Herman; John H Strickler; Al B Benson; Susan Urba; Nelson S Yee Journal: J Clin Oncol Date: 2016-05-31 Impact factor: 44.544
Authors: Alok A Khorana; Pamela B Mangu; Jordan Berlin; Anitra Engebretson; Theodore S Hong; Anirban Maitra; Supriya G Mohile; Matthew Mumber; Richard Schulick; Marc Shapiro; Susan Urba; Herbert J Zeh; Matthew H G Katz Journal: J Clin Oncol Date: 2016-05-31 Impact factor: 44.544
Authors: Mahmoud M Al-Hawary; Isaac R Francis; Suresh T Chari; Elliot K Fishman; David M Hough; David S Lu; Michael Macari; Alec J Megibow; Frank H Miller; Koenraad J Mortele; Nipun B Merchant; Rebecca M Minter; Eric P Tamm; Dushyant V Sahani; Diane M Simeone Journal: Radiology Date: 2014-01 Impact factor: 11.105
Authors: William H Sherman; Kyung Chu; John Chabot; John Allendorf; Beth Ann Schrope; Elizabeth Hecht; Brian Jin; David Leung; Helen Remotti; Gisella Addeo; Inna Postolov; Wei Tsai; Robert L Fine Journal: Cancer Date: 2014-12-09 Impact factor: 6.860
Authors: E Versteijne; J A Vogel; M G Besselink; O R C Busch; J W Wilmink; J G Daams; C H J van Eijck; B Groot Koerkamp; C R N Rasch; G van Tienhoven Journal: Br J Surg Date: 2018-04-30 Impact factor: 6.939