P-0105 Clinico-Pathological Prognostic Factors and Role of Plasmatic Vegf in Pancreas Cancer Patients

Abstract

IntroductionThe long term survival of patients with resectable pancreatic cancer (PC) is appalling, so data regarding what factors may influence outcome, following attempted curative resection is essential in order to optimize the treatment options for patients. Our aims were to analyze prognostic factors influencing survival in patients with resected PC in our institution. MethodsEligible participants included all persons diagnosed with pancreatic cancer from June 2004 to August 2008 that underwent pancreaticoduodenectomy for adenocarcinoma of only pancreatic head at the Surgical Department in Bellvitge Hospital. Risk factors associated with overall survival (OS) and Progression Free Survival (PFS) were assessed with the Kaplan-Meier survival method and the log-rank test. Demographic, tumour, and clinical variables were assessed using the Cox proportional hazards model. We also examined plasmatic VEGF (pVEGF) levels in these patients to evaluate the prognostic significance of these levels and correlate the results with the clinic- pathological features, microvascular density and K-RAS gene status. ResultsThe median follow-up was 17.8 months for all patients. The median follow-up for living patients was 40 months (range 3-83 months). The median survival time for all patients was 21.26 months (95% confidence interval 13.29-29.24 months).The median Progression Free Survival for all patients was 15.76 months (95% confidence interval 4.99-26.54 months). Pathological stage was unfavorable prognostic factor in our pancreas cancer patients by univariate and multivariate analysis for OS and PFS. Perineural and vascular invasion as well as R1 resection were also negative prognostic factors for PFS. There was no survival correlation between high levels of p-VEGF and the remaining clinico-pathological features (including the number of resected nodes, microvascular density or K-RAS gene status). ConclusionOur results are consistent with the most important published studies and tumor characteristics remain the best significant features influencing survival after pancreatic cancer surgery.