Higher overall survival in metastatic pancreatic cancer: the impact of where and how treatment is delivered

Abstract

Objective To determine the overall survival of patients with advanced pancreatic cancer and evaluate factors that impact prognosis in a private cancer center.Methods Data from the Hospital Cancer Registry at Hospital Israelita Albert Einstein were retrospectively collected. The patients enrolled had metastatic cancer at diagnosis or earlier staging and subsequent recurrence. Cases of neuroendocrine tumors were excluded.Results A total of 65 patients were evaluated, including 63 with adenocarcinoma. The median overall survival for patients in all stages was 20.7 months (95%CI: 15.6-25.7), while the overall survival of metastatic disease was 13.3 months. Among the 33 cases with stage IV cancer, there was no evidence of a statistically significant association between median survival and CA19-9 dosage (p=0.212), tumor location (p=0.482), first treatment performed (p=0.337), lymphovascular invasion (p=0.286), and age (p=0.152). However, the number of lines of chemotherapy was significantly associated with survival (log-rank p=0.013), with an estimated median survival of 10.2 months for patients who received up to two lines of treatment and 23.5 months for those receiving more than two lines of chemotherapy.Conclusion The survival of patients treated was longer than that reported in the literature. The only statistically significant factor related to increased survival was higher number of lines of chemotherapy received. We believe that the higher socioeconomic status of patients surveyed in this study, as well as their greater access to treatment options, may have influenced their overall survival.

The increasing burden of pancreatic cancer in Brazil from 2000 to 2019: estimates from the Global Burden of Disease Study 2019.

“…The results of this study, using standardized methodology, converge with the findings of studies using other methodologies, which show a tendency for an increase in the burden of pancreatic cancer in Brazil and worldwide [1][2][3]6,[18][19][21][22][23] . Moreover, this study described an evident influence of the level of social development in the magnitude and the annual growth of the rates of incidence and mortality in Brazil, in its states, as well as in the comparator countries.…”

“…It is unlikely that, in the studied period, the increase in lethality will explain the increase in mortality for pancreatic cancer. On the contrary, one can expect that a disease with such a high lethality will show a reduction due to the scientific efforts to obtain new treatments and the possibilities of early diagnosis 21 .…”

Chemotherapeutic efficacy of cucurmosin for pancreatic cancer as an alternative of gemcitabine: a comparative metabolomic study

“…In the absence of promising results for single-agent or combination chemotherapy in the last decades, prognosis remains poor. With multi-drug systemic treatment, the median survival rate is about 8 months (2,4). It is estimated that by 2020, there will be about 420,000 new cases and 410,000 deaths of pancreatic cancer in the world every year (5).…”

Patterns of care in metastatic pancreatic cancer: patient selection in clinical routine

“…Only a small subset of patients live significantly longer. 2 Based on the improved efficacy compared with gemcitabine monotherapy, gemcitabine + nab-paclitaxel (nanoparticle albumin bound paclitaxel) and mFOLFIRINOX [a modified regimen of oxaliplatin, leucovorin, irinotecan, and fluorouracil (5-FU)] are both established standard first-line treatments in patients with metastatic disease. 3–5 Since there is no head-to-head comparison between these regimens, multiple treatment options are applicable.…”