Universität zu Köln

Damanakis, Alexander I., Ostertag, Luisa, Waldschmidt, Dirk, Kuetting, Fabian, Quaas, Alexander, Plum, Patrick, Bruns, Christiane J., Gebauer, Florian and Popp, Felix (2019). Proposal for a definition of Oligometastatic disease in pancreatic cancer. BMC Cancer, 19 (1). LONDON: BMC. ISSN 1471-2407

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Abstract

Background: To date, patients with metastasized pancreatic ductal adenocarcinoma (PDAC M1) are regarded as a uniform collective. We hypothesize the existence of oligometastatic disease (OMD): a state of PDAC M1 disease with better tumor biology, limited metastasis, and increased survival. Methods: Data of 128 PDAC M1 patients treated at the University of Cologne between 2008 and 2018 was reviewed. Interdependence between clinical parameter was calculated using the Mann-Whitney U-Test. Survival curves were generated using the Kaplan-Meier method and analyzed using the log-rank test. Results: Eighty-one (63%) patients had metastases confined to one organ (single organ metastasis, SOG) whereas the remaining 47 (37%) showed multiple metastatic sites (multi-organ metastasis, MOG). Survival analysis revealed a median overall survival (OS) of 12.2 months for SOG vs 4.5 months for MOG (95% CI 5.7-9.8; p < 0.001). We defined limited disease by the presence of <= 4 metastases in liver or lung. Limited disease together with CA 19-9 baseline < 1000 U/ml and response or stable disease after first-line chemotherapy defined OMD. We identified 8 patients with hepatic metastases and 2 with pulmonary metastases matching all OMD criteria. This group of 10 (7.8%) had a median overall survival of 19.4 vs 7.2 months compared to the remaining patients (95% CI 5.7-9.8; p = 0.009). Conclusion: We propose a definition of oligometastatic disease in PDAC including anatomical criteria and biological criteria reflecting better tumor biology. The 10 OMD patients (7.8%) survived significantly longer and might even benefit from surgical resection in the future.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Damanakis, Alexander I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ostertag, Luisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Waldschmidt, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuetting, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Quaas, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Plum, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebauer, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Popp, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-123817
DOI:	10.1186/s12885-019-6448-9
Journal or Publication Title:	BMC Cancer
Volume:	19
Number:	1
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2407
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUCTAL ADENOCARCINOMA; NEOADJUVANT THERAPY; SURGICAL RESECTION; SERUM CA-19-9; SURVIVAL; SURGERY; IMPACT; METASTASES; TRENDS Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12381