Survival of Patients with Oligometastatic Pancreatic Ductal Adenocarcinoma Treated with Combined Modality Treatment Including Surgical Resection: A Pilot Study

被引:39
作者
Kandel, Pujan [1 ]
Wallace, Michael B. [1 ]
Stauffer, John [2 ]
Bolan, Candice [3 ]
Raimondo, Massimo [1 ]
Woodward, Timothy A. [1 ]
Gomez, Victoria [1 ]
Ritter, Ashton W. [4 ]
Asbun, Horacio [2 ]
Mody, Kabir [4 ]
机构
[1] Mayo Clin, Dept Gastroenterol & Hepatol, Jacksonville, FL 32224 USA
[2] Mayo Clin, Dept Surg, Jacksonville, FL 32224 USA
[3] Mayo Clin, Dept Radiol, Jacksonville, FL 32224 USA
[4] Mayo Clin, Dept Hematol & Oncol, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
关键词
ablation; metastasectomy; overall survival; pancreaticoduodenectomy; pancreatic cancer;
D O I
10.1089/pancan.2018.0011
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To evaluate the overall survival of patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC; metastatic tumor <4 cm, <= 2 metastatic tumors total) receiving neoadjuvant therapy, metastasectomy and/or ablation, and primary tumor resection. Methods: We performed a case-control study from January 2005 to December 2015. Patients who underwent curative-intent surgery combined modality therapy (M1 surgery group; 6 [14%], tumor [T]3, node [N]1, and oligometastases [M]1) were matched 1 to 3 based on TN stage with two control groups (M0 surgery and M1 no surgery). The M0 surgery group (18 [43%], T3, N1, and M0) included patients without metastases who underwent resection. The M1 no surgery group (18 [43%], T3, N1, and M1) included patients with metastatic PDAC who received palliative chemotherapy without surgical resection. Results: Median overall survival in the M1 surgery, M0 surgery, and M1 no surgery groups was 2.7 years (95% confidence interval [CI], 0.71-3.69), 2.02 years (95% CI, 0.98-3.05), and 0.98 years (95% CI, 0.55-1.25), respectively. Eastern Cooperative Oncology Group (ECOG) status was associated with survival (p = 0.01) after univariate analysis. After adjusting for ECOG status, multivariate analysis showed M1 surgery patients had improved survival compared with M1 no surgery patients and similar survival to M0 surgery patients. Conclusion: Multimodal therapy benefitted our M1 surgery patients. A larger, prospective study of this multidisciplinary management strategy is currently under way.
引用
收藏
页码:88 / 94
页数:7
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