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Predictors of systemic chemotherapy contraindication in pancreatic cancer patients with distant metastasis
Yong Zhang1, Chengxue Dang, Qingyong Ma
1Department of Hepatobiliary Surgery, The First Hospital of Xi'an Jiaotong University, Xi'an, China.
Background/Aims:
To investigate predictors of systemic chemotherapy contraindication in pancreatic cancer patients with distant metastasis.
Methodology:
Eighty-seven consecutive pancreatic cancer patients with distant metastasis receiving systemic chemotherapy using 5-fluorouracil, cisplatin or gemcitabine were analyzed retrospectively to investigate prognostic factors.
Results:
The overall median survival time of all patients in the whole series was 3.8 months, the 3-, 6, and 12-month probability of survival being 58%, 26%, and 3%, respectively. Significant poor prognostic factors were the age of 65 years old or older, presence of ascites, a total bilirubin > 2.5 mg/dL, ChE <110 IU/L, a higher level of tumor maker (CA19-9) and performance status <80 (p < 0.005). Cox proportional hazards model revealed independent poor prognostic factors were a presence of ascites, serum ChE level <110 IU/L, and age > or =65. A prognostic index was calculated based on the regression coefficients derived from the three variables according to their relative risk of death (RRD) = exp (presence of ascites x 1.213 + serum ChE level x 1.065 + age > or = 65 x 0.651).
Conclusions:
Ascites, ChE <110 IU/L, or age > or =65 should be chemotherapy contraindications for pancreatic cancer patients with distant metastasis because of their extremely short survival time and some other experimental approaches or supportive care are needed.
