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Analysis of Clinical Predictive Factors Affecting the Outcome of Second-Line Chemotherapy for Gemcitabine-Refractory Advanced Pancreatic Cancer

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dc.contributor.author박승우-
dc.contributor.author박정엽-
dc.contributor.author방승민-
dc.contributor.author송시영-
dc.contributor.author이정은-
dc.contributor.author이희승-
dc.contributor.author정문재-
dc.date.accessioned2020-02-26T06:43:19Z-
dc.date.available2020-02-26T06:43:19Z-
dc.date.issued2020-
dc.identifier.issn1976-2283-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/175265-
dc.description.abstractBackground/Aims: The benefit of second-line chemotherapy (SL) after failed first-line chemotherapy (FL) in patients with advanced pancreatic cancer has not yet been established. We evaluated the clinical characteristics affecting the benefits of SL compared to best supportive care (BSC), identified the prognostic factors, and ultimately devised a model of clinical parameters to assist in making decision between SL and BSC after the failure of gemcitabine-based FL. Methods: The records of patients who received gemcitabinebased FL for advanced pancreatic cancer at Yonsei University Hospital between January 2010 and December 2015 were retrospectively reviewed. Significant clinical parameters were assessed for their potential as predictive factors. Results: SL patients received a longer duration of FL compared with BSC patients with median duration being 16.0 weeks (range, 8.0 to 26.0 weeks) and 8.0 weeks (range, 4.0 to 16.0 weeks), respectively (p<0.001). When the SL group was stratified by their modified overall survival (mOS) (longer and shorter than 6 months), we found significant differences for several clinical factors, namely, metastasis to the peritoneum (p<0.001), number of metastases (p<0.001), thrombotic events (p=0.003), and level of carbohydrate antigen 19-9 (CA19- 9; p=0.011). In multivariate analysis, more than one site of metastasis, occurrence of thrombotic event during FL, and a CA19-9 level above 90 U/mL were significant independent prognostic factors for mOS in the SL group (p<0.05). When an attempt was made to devise a prognostic nomogram, Harrell's C-index of the final prognosis prediction model was 0.62. Conclusions: SL may be beneficial for patients without peritoneal metastasis or thrombotic events who have a single metastasis and a level of CA19-9 less than 90 U/mL. This prognostic nomogram can be used to predict mOS before the administration of SL after the failure of gemcitabinebased FL.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherEditorial Office of Gut and Liver-
dc.relation.isPartOfGUT AND LIVER-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleAnalysis of Clinical Predictive Factors Affecting the Outcome of Second-Line Chemotherapy for Gemcitabine-Refractory Advanced Pancreatic Cancer-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorJeung Eun Lee-
dc.contributor.googleauthorHee Seung Lee-
dc.contributor.googleauthorMoon Jae Chung-
dc.contributor.googleauthorJeong Youp Park-
dc.contributor.googleauthorSeung Woo Park-
dc.contributor.googleauthorSi Young Song-
dc.contributor.googleauthorSeungmin Bang-
dc.identifier.doi10.5009/gnl18419-
dc.contributor.localIdA01551-
dc.contributor.localIdA01647-
dc.contributor.localIdA01786-
dc.contributor.localIdA02035-
dc.contributor.localIdA03119-
dc.contributor.localIdA03349-
dc.contributor.localIdA03602-
dc.relation.journalcodeJ00954-
dc.identifier.eissn2005-1212-
dc.identifier.pmid30974927-
dc.subject.keywordPancreatic neoplasms-
dc.subject.keywordPrognostic model-
dc.subject.keywordSecond line chemotherapy-
dc.contributor.alternativeNamePark, Seung Woo-
dc.contributor.affiliatedAuthor박승우-
dc.contributor.affiliatedAuthor박정엽-
dc.contributor.affiliatedAuthor방승민-
dc.contributor.affiliatedAuthor송시영-
dc.contributor.affiliatedAuthor이정은-
dc.contributor.affiliatedAuthor이희승-
dc.contributor.affiliatedAuthor정문재-
dc.citation.volume14-
dc.citation.number1-
dc.citation.startPage135-
dc.citation.endPage143-
dc.identifier.bibliographicCitationGUT AND LIVER, Vol.14(1) : 135-143, 2020-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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