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Impact of Different Treatment Modalities on the Outcome of Pancreatic Cancer.
OBJECTIVE: To analyze overall survival patterns of our pancreatic cancer patient population managed with a curative or palliative intent.
STUDY DESIGN: Analytical study.
PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2000 till February 2015.
METHODOLOGY: Aretrospective review of the data of all of our pancreatic cancer patients was performed, using the hospital information system. Patients with tumor other than adenocarcinoma or a histopathologic diagnosis not made at our hospital are excluded from the study, along with patients having an incomplete medical record for all included variables. The main outcome measure was overall survival in months from the date of diagnosis. All results were segregated and analyzed according to the intervention modality used, i.e. group A: surgery with curative intent, group B: Palliative chemotherapy, and group C: Supportive care. Results were controlled for the confounding variables including age, gender, significant comorbid conditions, stage of disease at initial presentation, tumor location, and histological grade.
RESULTS: Among the 197 patients fulfilling the inclusion criteria, 21 (10.7%) were excluded as they were lost to follow-up. Overall Kaplan-Meier survival analysis gave a 56% one-year survival, 22% at 3- and 16% at 5-year. The subset analysis on Cox-regression survival plot showed inferior survival with advancing stage of the disease and a treatment less than definitive surgical resection and adjuvant chemotherapy. On Cox-proportional regression analysis, stage of the disease and treatment modality were only independent predictive factors for overall survival (p < 0.01).
CONCLUSION: Stage for stage, surgery with curative intent (group A) or palliative chemotherapy (group B) showed a trend towards improved survival as compared to supportive management (group C) alone. The results were more significant for surgical resection arm.
STUDY DESIGN: Analytical study.
PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2000 till February 2015.
METHODOLOGY: Aretrospective review of the data of all of our pancreatic cancer patients was performed, using the hospital information system. Patients with tumor other than adenocarcinoma or a histopathologic diagnosis not made at our hospital are excluded from the study, along with patients having an incomplete medical record for all included variables. The main outcome measure was overall survival in months from the date of diagnosis. All results were segregated and analyzed according to the intervention modality used, i.e. group A: surgery with curative intent, group B: Palliative chemotherapy, and group C: Supportive care. Results were controlled for the confounding variables including age, gender, significant comorbid conditions, stage of disease at initial presentation, tumor location, and histological grade.
RESULTS: Among the 197 patients fulfilling the inclusion criteria, 21 (10.7%) were excluded as they were lost to follow-up. Overall Kaplan-Meier survival analysis gave a 56% one-year survival, 22% at 3- and 16% at 5-year. The subset analysis on Cox-regression survival plot showed inferior survival with advancing stage of the disease and a treatment less than definitive surgical resection and adjuvant chemotherapy. On Cox-proportional regression analysis, stage of the disease and treatment modality were only independent predictive factors for overall survival (p < 0.01).
CONCLUSION: Stage for stage, surgery with curative intent (group A) or palliative chemotherapy (group B) showed a trend towards improved survival as compared to supportive management (group C) alone. The results were more significant for surgical resection arm.
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