gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Prognostic significance of local macroscopic and microscopic tumor factors at multimodality treated pancreatic patients

Meeting Abstract

  • corresponding author presenting/speaker Ralf Wilkowski - Universitätsklinikum Großhadern München, Deutschland
  • Christiane Bruns - Universitätsklinikum Großhadern München
  • Joachim Diebold - Universitätsklinikum Großhadern München
  • Volker Heinemann - Universitätsklinikum Großhadern München

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO193

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Veröffentlicht: 20. März 2006

© 2006 Wilkowski et al.
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Introduction: In early pancreatic cancer, the prognosis is unchangeably dismal specifically in patients with R1 resection or other local risk factors. However, an improvement of prognosis may be achieved for some patients through interdisciplinary treatment concepts.

Methods and Materials: Between 4/1999 and 4/2005, 105 patients undergoing resection of an adenocarcinoma of the pancreas received a postoperative chemoradiation using gemcitabine. They had histologically proven local risk factors (R1 resection and/or pN1 and/or L1).

The goal of this analysis was to evaluate the prognostic importance of the local macroscopic and microscopic tumor expansion.

Results: Median time to progression was 15.4 months (range 12.3_18.4) and the median actuarial overall survival of the patients was 25.3 months (range 18.8_31.7). It could be shown that patients with primary lymph node metastases have a significantly worse survival than patients in stage pN0 (pN0 –median not achieved, 5-year survival 54%, pN1 – median 22.4 months, 5-year survival 12%, p=0.003). Also tumor size turned out to have a significant impact on prognosis (TU</= 2 cm vs. > 2 cm; median 59.8 vs. 22.8 months, p=0.024). Neither the resection status (R0 vs R1) nor tumor localization (head vs corpus vs tail) were independent determinants of survival.

Conclusion: In high risk patients undergoing resection of localized pancreatic cancer, chemoradiotherapy, eliminated the prognostic importance of the resection status (R1 vs R0), while lymph node involvement and tumor size were observed as the only prognostic factors of survival.