Prognostic factors associated with short-term survival (STS) in advanced pancreatic cancer (APC): A multicenter analysis from the CHORD consortium.
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abstract
650 Background: The survival of patients (pts) with APC (locally advanced/metastatic) is slowly improving; however, in some pts it remains extremely short. Few studies have evaluated the clinical, pathologic and treatment characteristics associated with STS in APC. Methods: Pts with APC (between 2011-2017) were included in the analysis. Descriptive analyses were conducted for demographic, tumor and treatment characteristics between pts who survived ≤ and > 90 days using Wilcoxon rank-sum test and Chi-square test for continuous and categorical variables respectively. Multivariable logistic regression was performed to identify association between pts’ characteristics and STS. Results: A total of 580 pts were included in the analysis: median age 68, 53% male, 92% metastatic and 53% ECOG 0/1. STS ≤90 days occurred in 152 pts (26.2%), with 65.1% not receiving any chemotherapy. Median overall survival for STS was 49 days vs. 276 for non-STS. At least 1 cycle of chemotherapy was administered to 358 pts; mean duration of first-line chemotherapy for pts with STS ≤90 was 1.5(SD 2.5) cycles (N=53), compared to 7.6(SD 11.1) cycles (N=305) for pts surviving > 90 days. Prognostic factors associated with STS <90 days were neutrophil:lymphocyte ratio, LDH, metastatic disease, ECOG and not receiving chemotherapy (Table). Other clinical factors (BMI, smoking history, diabetes) and laboratory values (platelet, baseline CA19-9, estimated GFR) were not prognostic. Conclusions: In a multicenter database of Canadian academic centers, <2/3 of pts received at least 1 cycle of chemotherapy. Prognostic factors associated with STS include routine laboratory values, not receiving chemotherapy, ECOG and the presence of metastatic disease. Further evaluation of factors related to not receiving chemotherapy, and why chemotherapy is discontinued could improve the outcomes of pts with STS. [Table: see text]
