Predictors of Locoregional Failure and Impact on Overall Survival in Patients with Resected Exocrine Pancreatic Cancer

Kenneth W. Merrell, Michael Haddock, J. Fernando Quevedo, William S. Harmsen, Michael L. Kendrick, Robert C. Miller, Christopher Hallemeier

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose Resection of exocrine pancreatic cancer is necessary for cure, but locoregional and distant relapse is common. We evaluated our institutional experience to better understand risk factors for locoregional failure (LRF) and its impact on overall survival (OS). Methods and Materials We reviewed 1051 consecutive patients with nonmetastatic exocrine pancreatic cancer who underwent resection at our institution between March 1987 and January 2011. Among them, 458 had adequate follow-up and evaluation for study inclusion. All patients received adjuvant chemotherapy (n=80 [17.5%]) or chemoradiation therapy (n=378 [82.5%]). Chemotherapy and chemoradiation therapy most frequently consisted of 6 cycles of gemcitabine and 50.4 Gy in 28 fractions with concurrent 5-fluorouracil, respectively. Locoregional control (LRC) and OS were estimated with the Kaplan-Meier method. Univariate and multivariate analyses were performed with Cox proportional hazards regression models incorporating propensity score. Results Median patient age was 64.5 years (range: 29-88 years). Median follow-up for living patients was 84 months (range: 6-300 months). Extent of resection was R0 (83.8%) or R1 (16.2%). Overall crude incidence of LRF was 17% (n=79). The 5-year LRC for patients with and without radiation therapy was 80% and 68%, respectively (P=.003; hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.28-0.76). Multivariate analysis, incorporating propensity score, indicated radiation therapy (P

Original languageEnglish (US)
Pages (from-to)561-570
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume94
Issue number3
DOIs
StatePublished - 2016

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Fingerprint Dive into the research topics of 'Predictors of Locoregional Failure and Impact on Overall Survival in Patients with Resected Exocrine Pancreatic Cancer'. Together they form a unique fingerprint.

  • Cite this