Prognostic factors of long-term survivors with unresectable pancreatic cancer: a retrospective analysis

Despite the increasing number of patients with metastatic pancreatic adenocarcinoma (mPDAC) receiving second-line chemotherapy, little data have been reported about long-term survivors of mPDAC and prognostic factors. The study analyzes the prognostic variables of mPDAC in patients with a survival of 10 months or longer (long-term survivors). Patients registered in an institutional database receiving chemotherapy for mPDAC were selected, and two models defined the most relevant variables at baseline and after the first cycle of chemotherapy in short- and long-term survivors. A total of 110 patients were included, 69 short- and 41 long-term survivors. At baseline, long-term survivors reported significantly low rates of elevated carbohydrate antigen (CA) 19-9 (odds ratio [OR] 0.81, confidence interval [CI] 0.67-0.97) and liver involvement (OR 0.35, CI 0.14-0.90). After the first cycle of chemotherapy, polychemotherapy regimens (OR 5.26, CI 1.57-17.67) and neutrophil reduction (OR 0.16, CI 0.03-0.80) were the only independent variables associated with a long-term survivorship. mPDAC long-term survivors rarely present elevated serum CA 19-9 concentrations or liver metastases at baseline. Although they receive more intensive chemotherapy regimens, they more frequently experienced neutrophil reduction after the first cycle of chemotherapy regardless of the regimen.