Context The aim of the study was to determine risk factors of recurrence in resected pancreatic cancer. Methods We retrospectively analyzed 43 patients who underwent pancreatic resection for ductal adenocarcinoma, from January 2006 to December 2009. Demographic (age, sex), surgical (type of resection), pathological data (grading, TNM stage, lymph node ratio, R status, perineural and vascular invasion) and type of therapy (surgery alone versus surgery plus different adjuvant treatment) were evaluated. Adjuvant chemotherapy was performed in 24 patients with R0 status: 19 received gemcitabine alone (GEM) (1,000 mg/m2 days 1, 8, 15 every 28) and 5 GEM plus cisplatin (CDDP) (75 mg/m2 day 1 every 28). Radiotherapy was performed in 9 patients with R1 status: 6 associated with GEM alone and 3 with GEM plus CDDP. Results Overall survival (OS) and disease free survival (DFS) were (mean±SD) 23.3±3.8 and 12.8±1.2 months, respectively. Recurrence of disease occurred in 31 out of 43 patients (72.1%) with local relapse in 11 (35.5%) and distant metastases in 20 patients (65.5%). Among the prognostic factors evaluated, lymph node ratio and grading were significantly related to recurrence (lymph node ratio P=0.010; G1 vs. G2-G3, P=0.012). Regarding to postoperative treatment there were no significant differences between surgery alone versus surgery plus adjuvant therapy (median DFS: 16.8 versus 11 months; P=0.103). Risk of recurrence was increased in patients treated with chemo-radiotherapy compared those who received chemotherapy or surgery alone (P=0.042 and P=0.09, respectively). Conclusions The risk of recurrence was higher in patients treated with surgery plus chemoradiotherapy if compared to the others, probably because the combination treatment with additional radiotherapy was performed in R1 status patients.
Risk Factors in Resected Pancreatic Cancer. A Single Centre Experience / Macchini M1; Vecchiarelli S; Di Marco M; D’Ambra M; Ricci C; Pallotti MC; Melotti B; Sperandi F; Pezzilli R; Calculli L; Santini D; Barbieri E; Serra C; Casadei R; Minni F; Martoni AA; Biasco G. - In: JOP. JOURNAL OF THE PANCREAS. - ISSN 1590-8577. - ELETTRONICO. - 11 (5 suppl):(2010), pp. 527-527. (Intervento presentato al convegno AISP - 34th National Congress. tenutosi a Peschiera del Garda, VR (Italy). nel October 7-9, 2010).
Risk Factors in Resected Pancreatic Cancer. A Single Centre Experience
DI MARCO, MARIACRISTINA;Pallotti MC;CALCULLI, LUCIA;BARBIERI, ENZA;SERRA, CARLA;CASADEI, RICCARDO;MINNI, FRANCESCO;BIASCO, GUIDO
2010
Abstract
Context The aim of the study was to determine risk factors of recurrence in resected pancreatic cancer. Methods We retrospectively analyzed 43 patients who underwent pancreatic resection for ductal adenocarcinoma, from January 2006 to December 2009. Demographic (age, sex), surgical (type of resection), pathological data (grading, TNM stage, lymph node ratio, R status, perineural and vascular invasion) and type of therapy (surgery alone versus surgery plus different adjuvant treatment) were evaluated. Adjuvant chemotherapy was performed in 24 patients with R0 status: 19 received gemcitabine alone (GEM) (1,000 mg/m2 days 1, 8, 15 every 28) and 5 GEM plus cisplatin (CDDP) (75 mg/m2 day 1 every 28). Radiotherapy was performed in 9 patients with R1 status: 6 associated with GEM alone and 3 with GEM plus CDDP. Results Overall survival (OS) and disease free survival (DFS) were (mean±SD) 23.3±3.8 and 12.8±1.2 months, respectively. Recurrence of disease occurred in 31 out of 43 patients (72.1%) with local relapse in 11 (35.5%) and distant metastases in 20 patients (65.5%). Among the prognostic factors evaluated, lymph node ratio and grading were significantly related to recurrence (lymph node ratio P=0.010; G1 vs. G2-G3, P=0.012). Regarding to postoperative treatment there were no significant differences between surgery alone versus surgery plus adjuvant therapy (median DFS: 16.8 versus 11 months; P=0.103). Risk of recurrence was increased in patients treated with chemo-radiotherapy compared those who received chemotherapy or surgery alone (P=0.042 and P=0.09, respectively). Conclusions The risk of recurrence was higher in patients treated with surgery plus chemoradiotherapy if compared to the others, probably because the combination treatment with additional radiotherapy was performed in R1 status patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
