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Prognostic factors and prognostic index for chemonaïve and gemcitabine-refractory patients with advanced pancreatic cancer.

Abstract：

BACKGROUND:Gemcitabine monotherapy is the cornerstone of the treatment of patients suffering from advanced pancreatic cancer (PC). For a few years, new chemotherapeutic agents and combinations have been under validation. The use of such treatment makes it necessary to determine factors that could predict survival time. PATIENTS AND METHODS:To identify factors that predict survival time in chemonaïve patients with advanced PC and after gemcitabine failure, a retrospective analysis was performed on patients with advanced PC coming from phase II and III studies and treated with gemcitabine-based first-line chemotherapy. RESULTS:Ninety-nine patients (median age 66 years, range 27-87) suffering from pathologically proven unresectable or metastatic adenocarcinoma of the pancreas were reviewed. Median overall survival time for the whole population was 251 days and progression-free survival in first- and second-line treatment was 108 and 67 days, respectively. The Cox regression analysis identified aspartate transaminase >53 IU/l, weight loss > or =10% and Karnofsky performance status <90 as significant independent negative prognostic factors in first-line and CA 19-9 >400 IU/ml and albumin < or =3.5 mg/dl in second-line chemotherapy. A prognostic index was calculated from the regression coefficients for each independent prognostic factor and used to classify the patients in 3 different groups with good, intermediate and poor prognosis. The prognosis index in chemonaïve and gemcitabine-refractory patients was (Karnofsky performance status x 0.52) + (weight loss x 1.10) + (aspartate transaminase x 0.82) and (albumin x 1.40) + (CA 19-9 x 0.74), respectively. CONCLUSIONS:Predictive factors could be identified in first- and second-line treatments, although they require prospective validation before they could be used in the design and analysis of future clinical trials.

journal_name

Oncology

journal_title

Oncology

authors

Maréchal R,Demols A,Gay F,De Maertelaere V,Arvanitaki M,Hendlisz A,Van Laethem JL

doi

10.1159/000120627

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

41-51

issue

1-2

eissn

0030-2414

issn

1423-0232

pii

000120627

journal_volume

pub_type

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Prognostic factors and prognostic index for chemonaïve and gemcitabine-refractory patients with advanced pancreatic cancer.