Evaluation of Inoperable Pancreatic Carcinoma Based on Tumor Metastasis

Yasuhiko Miura, Michio Ueda, Toru Kubota, Itaru Endo, Hitoshi Sekido, Shinji Togo and Hiroshi Shimada

Department of Surgery-II, Yokohama City University, School of Medicine

Introduction: Many pancreatic cancers are detected only after they are far advanced, and thus show a poor prognosis. Methods: We evaluated the survival of patients with inoperable pancreatic carcinoma, and strategy treatment. Subjects were 72 persons with advanced inoperable pancreatic carcinoma selected from among 144 examined at our department from May 1992 to March 2001. Patient factors (age, gender, and nutrition), tumor factors (hepatic metastasis, peritoneal dissemination, and distant metastasis), and treatment (radiotherapy, systemic chemotherapy, and hepatic arterial infusion therapy (HAI)) were studied and survival evaluated statistically. Results: Overall mean survival was 175 days and the 1-year survival ratio was 13.5%. With multivariate analysis, prognostic factors were hepatic metastasis and radiotherapy. We therefore reevaluated 56 patients treated with radiotherapy. In the group with no hepatic metastasis whose mean survival was 247 days, the prognostic factor was systemic chemotherapy. In the group with hepatic metastasis, mean survival was 140 days and the prognostic factor was the prognostic nutritional index (PNI) on admission. HAI was also a significant factor, which prolonged survival time with univariate analysis. Conclusion: Radiotherapy will be conducted for all inoperable pancreatic carcinomas. For the group with no hepatic metastasis, systemic chemotherapy is effective and for the group with hepatic metastasis, HAI will be selected.

Key words
pancreatic cancer, radiotherapy, hepatic arterial infusion therapy

Reprint requests
Yasuhiko Miura Department of Surgery-II, Yokohama City University, School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JAPAN

Accepted
January 30, 2002

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