• Peng Xue, Masashi Kanai, Yukiko Mori, Takafumi Nishimura, Norimitsu Uza, Yuzo Kodama, Yoshiya Kawaguchi, Kyoichi Takaori, Shigemi Matsumoto, Shinji Uemoto, and Tsutomu Chiba.
• From the *Outpatient Oncology Unit, †Department of Gastroenterology and Hepatology, and ‡Department of Surgery, Graduate School of Medicine, Kyoto University Hospital, Kyoto, Japan.
• Pancreas. 2014 Apr 1;43(3):411-6.

ObjectivesThe objective of this study was to compare the clinical outcomes between initially unresectable and recurrent advanced pancreatic cancer (APC) patients after palliative chemotherapy.MethodsData of a total of consecutive 269 patients with pathologically confirmed APC patients who received palliative chemotherapy between January 2006 and April 2012 were reviewed. Patients were classified into initially unresectable and recurrent group, and overall survival (OS) was compared between the 2 groups.ResultsThe median OS was significantly longer in the recurrent group compared with the initially unresectable group (383 vs 308 days; hazard ratio [HR], 0.59; 95% confidence interval, 0.44-0.80; P < 0.01). After adjustment for distant metastasis, performance status, and levels of carbohydrate antigen 19-9, carcinoembryonic antigen, C-reactive protein, and lactate dehydrogenase, the status of recurrent or unresectable disease remained as an independent prognostic factor with a clinically relevant HR value (HR, 0.66; 95% confidence interval, 0.48-0.90; P = 0.01). In addition, the 2-year OS rate of the recurrent group was significantly higher than that of the unresectable group (24.2% vs 9.6%, P = 0.01).ConclusionsOur results suggested that the status of recurrent or initially unresectable disease was an independent prognostic factor in APC patients receiving palliative chemotherapy.

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