Onset Symptoms and Tumor Locations as Prognostic Factors of Pancreatic Cancer

Watanabe, Ichirô; Sasaki, Satoshi; Konishi, Masaru; Nakagohri, Toshio; Inoue, Kazuto; Oda, Tatsuya; Kinoshita, Taira

doi:10.1097/00006676-200403000-00007

Cited by 102 publications

(82 citation statements)

References 13 publications

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“…31,32 For example, back pain correlated with nonresectability and shorter survival. 32 Large pancreatic cancers and invasion of the pancreatic capsule and intrapancreatic nerves may cause back pain. 31 In contrast, we could not observe these correlations in patients with oral lesions.…”

Section: Discussionmentioning

confidence: 99%

Pain may predict poor prognosis in patients with oral squamous cell carcinoma

Sato

Yamazaki

Satoh

et al. 2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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Objectives:We have previously reported that the histological mode of invasion of oral squamous cell carcinoma (OSCC) is a significant risk factor for pain. We sought to determine whether pain is a risk factor for poor prognosis in patients with OSCC. Study Design:We evaluated the relationships between overall survival rates (OSRs) and clinicopathological variables, including gender, age, Tand N-stages, pathological findings and pain in 109 consecutive patients with untreated OSCC. Results:Of these 109 patients, 40 (37%) reported spontaneous pain.Univariate analysis showed that the OSR of patients with spontaneous pain was significantly lower than that of patients without pain (p=0.002).Multivariate analysis revealed that spontaneous pain and N-stage were significant independent predictors of OSR. Conclusion:This is the first report showing that spontaneous pain before treatment may be associated with poor prognosis in patients with OSCC.3

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Section: Discussionmentioning

confidence: 99%

Pain may predict poor prognosis in patients with oral squamous cell carcinoma

Sato

Yamazaki

Satoh

et al. 2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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“…Also, many possible prognostic factors have been identified in advanced pancreatic cancer (Table 1), most derived from retrospective studies based on small numbers of patients resulting in analyses that may be underpowered. A total of 34 possible factors were identified from 36 studies (4 randomised controlled trials; Johnson et al, 2001;Berlin et al, 2002;Ducreux et al, 2002;Maisey et al, 2002) and 32 consecutive series (Friedman and van den Eeden, 1993;Yasue et al, 1994;Falconer et al, 1995;Lundin et al, 1995;Ishii et al, 1996;Rothenberg et al, 1996;Shibamoto et al, 1996;Cubiella et al, 1999;Storniolo et al, 1999;Halm et al, 2000;Terwee et al, 2000;Trigui et al, 2000;Ueno et al, 2000;Ikeda et al, 2001;Ridwelski et al, 2001;Tas et al, 2001;Tsuruta et al, 2001;Saad et al, 2002;Bachmann et al, 2003;Engelken et al, 2003;Fujino et al, 2003;Karayiannakis et al, 2003;Micke et al, 2003;Ohigashi et al, 2003;Paillaud et al, 2003;Stemmler et al, 2003;Talar-Wojnarowska et al, 2003;Ziske et al, 2003;Gupta et al, 2004;Kuhlmann et al, 2004;Watanabe et al, 2004;Ni et al, 2005) of which 15 had o100 patients (Yasu...…”

Section: Discussionmentioning

confidence: 99%

Modelling prognostic factors in advanced pancreatic cancer

et al. 2008

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Pancreatic cancer is the fifth most common cause of cancer death. Identification of defined patient groups based on a prognostic index may improve the prediction of survival and selection of therapy. Many prognostic factors have been identified often based on retrospective, underpowered studies with unclear analyses. Data from 653 patients were analysed. Continuous variables are often simplified assuming a linear relationship with log hazard or introducing a step function (dichotomising). Misspecification may lead to inappropriate conclusions but has not been previously investigated in pancreatic cancer studies. Models based on standard assumptions were compared with a novel approach using nonlinear fractional polynomial (FP) transformations. The model based on FP-transformed covariates was most appropriate and confirmed five previously reported prognostic factors: albumin, CA19-9, alkaline phosphatase, LDH and metastases, and identified three additional factors not previously reported: WBC, AST and BUN. The effects of CA19-9, alkaline phosphatase, AST and BUN may go unrecognised due to simplistic assumptions made in statistical modelling. We advocate a multivariable approach that uses information contained within continuous variables appropriately. The functional form of the relationship between continuous covariates and survival should always be assessed. Our model should aid individual patient risk stratification and the design and analysis of future trials in pancreatic cancer.

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“…Pancreatic head masses, which would lead to obstructive jaundice, were more likely to present as malignancies in some researches 10,20,23 . The same result was obtained in the present study as well.…”

Section: Resultsmentioning

confidence: 99%

“…Patients bearing malignant tumors in pancreatic head were more likely to present with abdominal pain (63.77% versus 45.95% in our study). Although abdominal pain was nonspecific 18 , it was the most frequent onset symptom in pancreatic cancer 15,19 , and it was proven to have certain relation with tumor location in pancreatic adenocarcinoma 20 . On the other hand, patients with benign lesions did not often appear with abdominal pain until it reached considerable size and gave rise to the obstruction of the pancreatico-biliary duct 21 .…”

Section: Resultsmentioning

confidence: 99%

“…Since malignant patients with onset symptom of jaundice were more likely to have tumors located in the pancreatic head 20 and jaundice closely correlated with serum bilirubin 20 , the serum bilirubin level was supposed to serve as a helpful diagnostic candidate. In our study, the difference of bilirubin levels between malignant and benign tumors was substantial (pTB<0.001,pD-B<0.001,pIB<0.001).…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels

Jin¹,

Wu²

2015

Afr H. Sci.

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Background: Carbohydrate antigen (CA)19-9 that is the most widely used biomarker for pancreatic cancer has certain limitations in diagnosis, which results in a tough job to distinguish pancreatic cancer from benign tumors with normal CA19-9. The aim of this study was to investigate the diagnostic utility of clinical parameters and serum markers in patients with pancreatic head masses but without elevated CA19-9. Methods: Retrospectively, 106 (69 malignant, 37 benign) of 487 patients admitted for pancreatic head masses were enrolled with CA19-9 level of <37u/ml. Clinical parameters and serum biomarkers were assessed. Among the patients with pancreatic head mass, male individuals (p=0.025) and elder individuals (p<0.001) were more likely to have cancer; and cancer patients were more likely to present with abdominal-pain (p=0.023), weight-loss (p=0.013) and jaundice (p<0.001). Serum bilirubin levels among malignancies, including total bilirubin (p<0.001), direct bilirubin (p<0.001) and indirect bilirubin (p<0.001), were considerably higher than those of benign ones. Logistic regression further concluded that age-distribution, abdominal-pain and direct-bilirubin were three independent factors correlating with final diagnosis. However, CEA (p=0.156) was not sufficient enough to exclude pancreatic cancer. Conclusions: In patients with pancreatic head masses and CA19-9 of <37u/ml, age-distribution, abdominal-pain and direct bilirubin might be helpful in differential diagnosis. CEA was insufficient for exclusion of malignancy.

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Onset Symptoms and Tumor Locations as Prognostic Factors of Pancreatic Cancer

Abstract: The onset symptom of patients with pancreatic carcinoma closely correlates with prognosis.

Cited by 102 publications

References 13 publications

Pain may predict poor prognosis in patients with oral squamous cell carcinoma

Pain may predict poor prognosis in patients with oral squamous cell carcinoma

Modelling prognostic factors in advanced pancreatic cancer

Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels

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