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Impact of splenectomy on thrombocytopenia, chemotherapy, and survival in patients with unresectable pancreatic cancer.

Donahue TR, Kazanjian KK, Isacoff WH, Reber HA, Hines OJ - J. Gastrointest. Surg. (2010)

Bottom Line: The overall survival of patients with PDAC was compared to historical controls.All patients were able to resume chemotherapy within a median of 11.5 days (range 6-27).Patients with PDAC had better disease-specific survival as compared to historical controls.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of General Surgery, David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Avenue, CHS, Room 72-215, Los Angeles, CA 90095-6904, USA. tdonahue@mednet.ucla.edu

ABSTRACT

Background: Patients with unresectable pancreatic cancer (PDAC) or endocrine tumors (PET) often develop splenic vein thrombosis, hypersplenism, and thrombocytopenia which limits the administration of chemotherapy.

Methods: From 2001 to 2009, 15 patients with recurrent or unresectable PDAC or PET underwent splenectomy for hypersplenism and thrombocytopenia. The clinical variables of this group of patients were analyzed. The overall survival of patients with PDAC was compared to historical controls.

Results: Of the 15 total patients, 13 (87%) had PDAC and 2 (13%) had PET. All tumors were either locally advanced (n = 6, 40%) or metastatic (n = 9, 60%). The platelet counts significantly increased after splenectomy (p < 0.01). All patients were able to resume chemotherapy within a median of 11.5 days (range 6-27). The patients with PDAC had a median survival of 20 months (range 4-67) from the time of diagnosis and 10.6 months (range 0.6-39.8) from the time of splenectomy.

Conclusions: Splenectomy for patients with unresectable PDAC or PET who developed hypersplenism and thrombocytopenia that limited the administration of chemotherapy, significantly increased platelet counts, and led to resumption of treatment in all patients. Patients with PDAC had better disease-specific survival as compared to historical controls.

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Related in: MedlinePlus

Disease-specific survival of 13 patients with PDAC. Median survival was 20 months (range 4–67 months).
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Fig2: Disease-specific survival of 13 patients with PDAC. Median survival was 20 months (range 4–67 months).

Mentions: The median follow-up for all survivors was 35 months (range 13–63) from the time of diagnosis and 25 months (range 0.6–51) from the time of splenectomy. The 13 patients with PDAC had a median survival of 20 months (range 4–67) with a 5-year DSS of 25% from the time of diagnosis, and a median DSS of 10.6 months (range 0.6–39.8) from the time of splenectomy (Fig. 2). Both patients with PET had well-differentiated tumors. One patient died of disease after 107 months, and the other is still alive with disease after 60 months.Figure 2


Impact of splenectomy on thrombocytopenia, chemotherapy, and survival in patients with unresectable pancreatic cancer.

Donahue TR, Kazanjian KK, Isacoff WH, Reber HA, Hines OJ - J. Gastrointest. Surg. (2010)

Disease-specific survival of 13 patients with PDAC. Median survival was 20 months (range 4–67 months).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2872015&req=5

Fig2: Disease-specific survival of 13 patients with PDAC. Median survival was 20 months (range 4–67 months).
Mentions: The median follow-up for all survivors was 35 months (range 13–63) from the time of diagnosis and 25 months (range 0.6–51) from the time of splenectomy. The 13 patients with PDAC had a median survival of 20 months (range 4–67) with a 5-year DSS of 25% from the time of diagnosis, and a median DSS of 10.6 months (range 0.6–39.8) from the time of splenectomy (Fig. 2). Both patients with PET had well-differentiated tumors. One patient died of disease after 107 months, and the other is still alive with disease after 60 months.Figure 2

Bottom Line: The overall survival of patients with PDAC was compared to historical controls.All patients were able to resume chemotherapy within a median of 11.5 days (range 6-27).Patients with PDAC had better disease-specific survival as compared to historical controls.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of General Surgery, David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Avenue, CHS, Room 72-215, Los Angeles, CA 90095-6904, USA. tdonahue@mednet.ucla.edu

ABSTRACT

Background: Patients with unresectable pancreatic cancer (PDAC) or endocrine tumors (PET) often develop splenic vein thrombosis, hypersplenism, and thrombocytopenia which limits the administration of chemotherapy.

Methods: From 2001 to 2009, 15 patients with recurrent or unresectable PDAC or PET underwent splenectomy for hypersplenism and thrombocytopenia. The clinical variables of this group of patients were analyzed. The overall survival of patients with PDAC was compared to historical controls.

Results: Of the 15 total patients, 13 (87%) had PDAC and 2 (13%) had PET. All tumors were either locally advanced (n = 6, 40%) or metastatic (n = 9, 60%). The platelet counts significantly increased after splenectomy (p < 0.01). All patients were able to resume chemotherapy within a median of 11.5 days (range 6-27). The patients with PDAC had a median survival of 20 months (range 4-67) from the time of diagnosis and 10.6 months (range 0.6-39.8) from the time of splenectomy.

Conclusions: Splenectomy for patients with unresectable PDAC or PET who developed hypersplenism and thrombocytopenia that limited the administration of chemotherapy, significantly increased platelet counts, and led to resumption of treatment in all patients. Patients with PDAC had better disease-specific survival as compared to historical controls.

Show MeSH
Related in: MedlinePlus