Document Detail

Evaluation of preoperative therapy for pancreatic cancer using a prognostic nomogram.
MedLine Citation:
PMID:  17013688     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Theoretical benefits of preoperative chemoradiation therapy (preop CRT) for pancreatic cancer include improved efficacy, resectability, and patient selection. The goal of this study was to evaluate the applicability of a nomogram, which was developed for patients undergoing resection without preop CRT and which incorporates several post-resection pathological factors, to a population of patients who received preop CRT prior to resection. METHODS: From 1994 to 2004, 82 patients with biopsy-proven, radiographically localized adenocarcinoma of the pancreatic head underwent preop CRT followed by pancreaticoduodenectomy (PD); 50 concurrent patients underwent PD without preop CRT. Mean nomogram-predicted disease-specific survival (DSS) rates were compared with observed DSS rates from the time of resection. RESULTS: Despite having more locally advanced tumors on initial staging (21 vs. 8%; P < .05), patients who received preop CRT had smaller resected tumors (mean 2.3 vs. 3.1 cm; P < .01), were less likely to have T3 tumors (54 vs. 80%, P < .01), were less likely to have positive lymph nodes (29 vs. 58%, P < .01), and had fewer positive lymph nodes (mean .4 vs. 1.9, P < .01), all factors that imply treatment effect and favorably impact on nomogram-predicted DSS. Observed DSS was similar to predicted DSS in both groups. CONCLUSIONS: The similarity in observed and predicted DSS following resection in patients who received preop CRT suggests that the effects of preop CRT-whether treatment, selection, or no effect-are reflected by the nomogram. The ability of the nomogram to evaluate the effects of preop CRT on survival is limited by the potential effects of preop CRT on factors within the nomogram.
Rebekah R White; Michael W Kattan; John C Haney; Bryan M Clary; Theodore N Pappas; Douglas S Tyler; Murray F Brennan
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2006-09-30
Journal Detail:
Title:  Annals of surgical oncology     Volume:  13     ISSN:  1068-9265     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-19     Completed Date:  2007-02-01     Revised Date:  2007-07-18    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1485-92     Citation Subset:  IM    
Department of Surgical Oncology, Memorial Sloan-Kettering Cancer Center, New York 10021, USA.
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MeSH Terms
Adenocarcinoma / drug therapy,  radiotherapy,  surgery
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Chemotherapy, Adjuvant
Combined Modality Therapy
Middle Aged
Pancreatic Neoplasms / drug therapy,  radiotherapy,  surgery,  therapy*
Preoperative Care*
Radiotherapy, Adjuvant

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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