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Evaluation of DNA ploidy in relation with established prognostic factors in patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma: a retrospective analysis.

Tsavaris N, Kavantzas N, Tsigritis K, Xynos ID, Papadoniou N, Lazaris A, Kosmas C, Agrogiannis G, Dokou A, Felekouras E, Antoniou E, Polyzos A, Sarantonis J, Tsipras H, Karatzas G, Papalambros A, Patsouris ES - BMC Cancer (2009)

Bottom Line: On multivariate analysis, 10 factors had an independent effect on survival: performance status, local extension of tumor, distant metastases, ploidy score, anemia under epoetin therapy, weight loss, pain, steatorrhoea, CEA, and palliative surgery and chemotherapy.Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 and these with ploidy score 2.2-3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2.According to the significance of the examined factor, survival was improved mainly by the combination of surgery and chemotherapy, and the presence of low DNA ploidy score.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oncology Unit, Department of Pathophysiology, Laikon General Hospital, Athens University School of Medicine, Athens, Greece. tsavari1@otenet.gr

ABSTRACT

Background: Most patients with ductal pancreatic adenocarcinoma are diagnosed with locally advanced (unresectable) or metastatic disease. The aim of this study was to evaluate the prognostic significance of DNA ploidy in relation with established clinical and laboratory variables in such patients.

Methods: Two hundred and twenty six patients were studied retrospectively. Twenty two potential prognostic variables (demographics, clinical parameters, biochemical markers, treatment modality) were examined.

Results: Mean survival time was 38.41 weeks (95% c.i.: 33.17-43.65), median survival 27.00 weeks (95% c.i.: 23.18-30.82). On multivariate analysis, 10 factors had an independent effect on survival: performance status, local extension of tumor, distant metastases, ploidy score, anemia under epoetin therapy, weight loss, pain, steatorrhoea, CEA, and palliative surgery and chemotherapy. Patients managed with palliative surgery and chemotherapy had 6.7 times lower probability of death in comparison with patients without any treatment. Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 and these with ploidy score 2.2-3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2.

Conclusion: According to the significance of the examined factor, survival was improved mainly by the combination of surgery and chemotherapy, and the presence of low DNA ploidy score.

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Survival data according to therapy.
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Figure 4: Survival data according to therapy.

Mentions: Patients with PS 80 had 3.0 times lower probability of death in comparison with patients with PS 50, and patients with PS 90 had 3.9 times lower probability of death in comparison with patients with PS 50. Patients with distant metastases in lymph nodes, liver or the abdomen had 2.5 times higher probability of death in comparison with patients without. Patients at local extension of the tumor stage 2 had 2.8 times higher probability of death in comparison with patients at stage 1. Patients with with moderate anaemia under epoetin therapy had 1.5 times lower probability of death in comparison with patients without. Patients with weight loss 1–5% or 5–10% of body weight had 3.0 times lower probability of death in comparison with patients with weight loss > 10%. Patients with steatorrhoea had 1.8 times higher probability of death in comparison with patients without. Patients with CEA > 5 mg/dL had 1.4 times higher probability of death in comparison with patients with CEA < 5 mg/dL. Patients with moderate pain had 2.1 times lower probability of death in comparison with patients with severe pain. Patients with ploidy score 2.2–3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2. Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 (Figure 3). Patients with only chemotherapy had 4.2 times lower probability of death in comparison with patients without any treatment. Patients with chemotherapy and surgery had 6.7 times lower probability of death in comparison with patients without any treatment (Figure 4).


Evaluation of DNA ploidy in relation with established prognostic factors in patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma: a retrospective analysis.

Tsavaris N, Kavantzas N, Tsigritis K, Xynos ID, Papadoniou N, Lazaris A, Kosmas C, Agrogiannis G, Dokou A, Felekouras E, Antoniou E, Polyzos A, Sarantonis J, Tsipras H, Karatzas G, Papalambros A, Patsouris ES - BMC Cancer (2009)

Survival data according to therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2734865&req=5

Figure 4: Survival data according to therapy.
Mentions: Patients with PS 80 had 3.0 times lower probability of death in comparison with patients with PS 50, and patients with PS 90 had 3.9 times lower probability of death in comparison with patients with PS 50. Patients with distant metastases in lymph nodes, liver or the abdomen had 2.5 times higher probability of death in comparison with patients without. Patients at local extension of the tumor stage 2 had 2.8 times higher probability of death in comparison with patients at stage 1. Patients with with moderate anaemia under epoetin therapy had 1.5 times lower probability of death in comparison with patients without. Patients with weight loss 1–5% or 5–10% of body weight had 3.0 times lower probability of death in comparison with patients with weight loss > 10%. Patients with steatorrhoea had 1.8 times higher probability of death in comparison with patients without. Patients with CEA > 5 mg/dL had 1.4 times higher probability of death in comparison with patients with CEA < 5 mg/dL. Patients with moderate pain had 2.1 times lower probability of death in comparison with patients with severe pain. Patients with ploidy score 2.2–3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2. Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 (Figure 3). Patients with only chemotherapy had 4.2 times lower probability of death in comparison with patients without any treatment. Patients with chemotherapy and surgery had 6.7 times lower probability of death in comparison with patients without any treatment (Figure 4).

Bottom Line: On multivariate analysis, 10 factors had an independent effect on survival: performance status, local extension of tumor, distant metastases, ploidy score, anemia under epoetin therapy, weight loss, pain, steatorrhoea, CEA, and palliative surgery and chemotherapy.Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 and these with ploidy score 2.2-3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2.According to the significance of the examined factor, survival was improved mainly by the combination of surgery and chemotherapy, and the presence of low DNA ploidy score.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oncology Unit, Department of Pathophysiology, Laikon General Hospital, Athens University School of Medicine, Athens, Greece. tsavari1@otenet.gr

ABSTRACT

Background: Most patients with ductal pancreatic adenocarcinoma are diagnosed with locally advanced (unresectable) or metastatic disease. The aim of this study was to evaluate the prognostic significance of DNA ploidy in relation with established clinical and laboratory variables in such patients.

Methods: Two hundred and twenty six patients were studied retrospectively. Twenty two potential prognostic variables (demographics, clinical parameters, biochemical markers, treatment modality) were examined.

Results: Mean survival time was 38.41 weeks (95% c.i.: 33.17-43.65), median survival 27.00 weeks (95% c.i.: 23.18-30.82). On multivariate analysis, 10 factors had an independent effect on survival: performance status, local extension of tumor, distant metastases, ploidy score, anemia under epoetin therapy, weight loss, pain, steatorrhoea, CEA, and palliative surgery and chemotherapy. Patients managed with palliative surgery and chemotherapy had 6.7 times lower probability of death in comparison with patients without any treatment. Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 and these with ploidy score 2.2-3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2.

Conclusion: According to the significance of the examined factor, survival was improved mainly by the combination of surgery and chemotherapy, and the presence of low DNA ploidy score.

Show MeSH
Related in: MedlinePlus