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Survival analysis of veteran patients with pancreatic cancer
Author(s) -
Kim David,
Zhu Hong,
Nassri Ammar,
Mokdad Ali,
Kukreja Sachin,
Polanco Patricio,
Huerta Sergio,
Ramzan Zeeshan
Publication year - 2016
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12361
Subject(s) - medicine , pancreatic cancer , stage (stratigraphy) , adenocarcinoma , cancer , palliative care , univariate analysis , abdominal pain , chemotherapy , oncology , metastasis , multivariate analysis , ca19 9 , confidence interval , gastroenterology , paleontology , nursing , biology
Objective For patients with pancreatic cancer, the identification of reliable predictors of their outcomes could be invaluable for directing the managements. This study aimed to identify clinical and laboratory factors that could be used to predict early (≤6 months) or late (>6 months) mortality. Methods Medical records of patients diagnosed with pancreatic cancer in the VA North Texas Health Care System from 2005 to 2010 were retrospectively reviewed. Univariate and multivariate analyses (MVA) were performed and the utility of cancer antigen 19‐9 (CA19‐9) test was explored. Results Altogether 109 patients with pancreatic cancer, 89.0% of whom were with adenocarcinoma, were divided into early ( n = 62) and late ( n = 47) mortality groups. Kaplan–Meier analysis revealed a median survival of 154 days [95% confidence interval (CI) 93–194 days]. On MVA, abdominal pain (OR = 10.6, P = 0.009) and large tumor size (OR = 2.4, P = 0.028) were significantly associated with early mortality, while palliative chemotherapy (OR = 0.048, P = 0.001) and neuroendocrine tumor (OR = 0.009, P = 0.024) were significantly associated with late mortality. Subgroup analyses of adenocarcinoma and late‐stage patients revealed similar results. Serum CA19‐9 performed poorly as a prognostic indicator in both groups ( P = 0.43), in metastatic disease at diagnosis ( P = 0.32) and after treatment ( P = 0.65). Conclusions Abdominal pain and large tumor size portends a poor prognosis in patients with pancreatic cancer. Palliative chemotherapy and surgical intervention may prolong the patient's survival. CA19‐9 is not universally reliable for predicting metastasis, survival, or the responses to chemotherapy.