Long-Term Survivors in Metastatic Pancreatic Ductal Adenocarcinoma: A Retrospective and Matched Pair Analysis
Long-Term Survivors in Metastatic Pancreatic Ductal Adenocarcinoma: A Retrospective and Matched Pair Analysis
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DOI：
10.1634/theoncologist.2018-0786
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发表时间：
2019-12-01
期刊：
影响因子：
5.8
通讯作者：
de la Fouchardiere, Christelle
中科院分区：
文献类型：
--
作者：
Rochefort, Pauline;Lardy-Cleaud, Audrey;de la Fouchardiere, Christelle
背景转移性胰腺导管腺癌(MPDAC)是一种侵袭性恶性肿瘤，中位总生存期(OS)为8~11个月。然而，相当数量的患者经历了更长的生存时间，超过18个月。本研究的目的是描述长期存活者的人群，并评估可能影响存活率的临床和病理因素。材料与方法确定所有在2010年1月至2015年6月期间在法国里昂贝拉德中心确诊并存活超过18个月的mPDAC患者。他们与年龄、性别、表现状态、诊断阶段、原发肿瘤定位、治疗和肝转移相匹配的对照队列进行比较。结果共纳入94例患者，每组47例。两个队列具有相同的特征：女性(51%)，工作状态5=0.31)，腹膜癌(OR(参考文献：是)=0.40)。NLR是我们反向选择过程中唯一剩下的因素。结论2018年，相当一部分mPDAC患者可以实现长期生存(=18个月)。我们发现低NLR是影响胰腺癌患者长期生存的重要预后因素。转移性胰腺导管腺癌是最致命的癌症类型之一。部分mPDAC患者可以通过现代化疗方案(如FOLFIRINOX或吉西他滨/NAB-紫杉醇)获得长期生存(=18个月)。我们发现低中性粒细胞/淋巴细胞比率(NLR)是与mPDAC长期生存相关的一个重要预后因素。预后因素，如NLR，可能允许准确选择mPDAC患者，以便考虑个体化治疗方法。NLR应作为临床试验的分层因子。
Background Metastatic pancreatic ductal adenocarcinoma (mPDAC) is an aggressive malignancy with a median overall survival (OS) of between 8 and 11 months. However, a significant number of patients experience a longer survival, more than 18 months. The aim of this study was to describe the "long-term survivor" population and to evaluate clinical and pathological factors that might affect survival.Materials and Methods All patients with mPDAC diagnosed in the Centre Leon Berard (Lyon, France) between January 2010 and June 2015 and who survived more than 18 months were identified. They were compared with a control cohort matched on age, sex, performance status, stage at diagnosis, primary tumor localization, treatment, and liver metastasis. Their clinical features, treatment modalities, and outcomes were analyzed.Results A total of 94 patients were included, 47 in each cohort. Both cohorts had identical characteristics as follows: women (51%), performance status 5) = 0.31), and peritoneal carcinomatosis (OR (ref: yes) = 0.40). NLR was the only remaining factor in our backward selection procedure.Conclusion A significant subset of patients with mPDAC can achieve long-term survival (>= 18 months) in 2018. We identified low NLR as a significant prognostic factor associated with long-term survival in mPDAC.Implications for Practice Metastatic pancreatic ductal adenocarcinoma (mPDAC) is one of the most lethal types of cancer. A subset of patients with mPDAC can achieve long-term survival (>= 18 months) with a modern chemotherapy regimen, such as FOLFIRINOX or gemcitabine/nab-paclitaxel. We identified low neutrophil-to-lymphocyte ratio (NLR) as a significant prognostic factor associated with long-term survival in mPDAC. Prognostic factors such as NLR might allow accurate selection of patients with mPDAC in order to consider individual therapeutic approaches. NLR should be used as a stratification factor in clinical trials.