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Japanese Journal of Clinical Oncology Advance Access originally published online on February 1, 2007
Japanese Journal of Clinical Oncology 2007 37(2):114-120; doi:10.1093/jjco/hyl144
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© 2007 Foundation for Promotion of Cancer Research

Prognostic Factors in Patients with Gemcitabine-Refractory Pancreatic Cancer

Kohei Nakachi, Junji Furuse, Hiroshi Ishii, Ei-ichiro Suzuki and Masahiro Yoshino

Division of Hepatobiliary and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

For reprints and all correspondence: Kohei Nakachi, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa Chiba, 277-8577, Japan. E-mail: konakach{at}east.ncc.go.jp

Received June 7, 2006; accepted October 2, 2006

Objective: The purpose of this study was to identify prognostic factors in patients with gemcitabine-refractory pancreatic cancer and to determine criteria for selecting candidates for second-line treatment.

Methods: The records of 74 patients who were treated with gemcitabine (GEM) and followed up until disease progression were reviewed retrospectively. Sixteen clinical variables at the time of disease progression after GEM chemotherapy were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival.

Results: At the time of analysis, 71 patients had died because of tumor progression. The overall median survival time was 5.1 months after first-line chemotherapy with GEM was initiated. Median survival time after disease progression was 2.0 months. Three factors, performance status, peritoneal dissemination and C-reactive protein level, were identified as independent prognostic factors in multivariate analysis. Median survival time in the good prognosis group (patients with performance status 0 or 1, no peritoneal dissemination and C-reactive protein <5.0 mg/dl) was 3.4 months.

Conclusions: Performance status, serum level of C-reactive protein and peritoneal dissemination were identified as important prognostic factors in patients with GEM-refractory pancreatic cancer. These factors should be considered in determining the treatment following first-line chemotherapy in patients with advanced pancreatic cancer.

Key Words: pancreatic neoplasms • gemcitabine • prognosis • salvage therapy


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