New study identifies valuable tool for treating pancreatic cancer patients

March 10, 2020

Pancreatic cancer is predicted to become the second leading cause of cancer-related deaths by 2030. However, recent developments in staging and treatment provide options to improve the long-term survival rate for an otherwise devastating diagnosis.

Today, new research published in Annals of Surgery from the University of Colorado Department of Surgery at the Anschutz Medical Campus offers a roadmap to new guidelines for physicians in prioritizing treatments and improving outcomes through surgery.

The study suggests a new concept of resectability and identifies objective pre-operative prognostic factors that can predict long-term survival of patients affected by pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic cancer.

"Our research suggests that a new concept of resectability should be considered that is meant to reflect the biology of the tumor and response to chemotherapy," said Marco Del Chiaro, MD, PhD, FACS, Chief of Surgical Oncology and Director of the National Pancreas Foundation Center of Excellence at the Anschutz Medical Campus. "Therefore, this will partially overcome the existing guidelines that are mostly based on tumor anatomic features. Tumor anatomic features are extremely subjective and vary between center to center and surgeon to surgeon."

In the study, researchers analyzed nearly 8,000 patients who underwent pancreatic resection for PDAC from January 2010 to December 2016. The research found that the main prognostic factors for survival were age, sex, levels of carbohydrate antigen CA 19-9, tumor size, primary site, neo-adjuvant treatment (a treatment given to shrink a tumor before surgery), Charlson/Deyo score and facility type. For example, academic facilities were associated with better survival rates. The strength of the findings were validated by a high significant randomized test, log-rank test and simple hazard ratio.

One of the most critical findings is that the tumor engagement of peri-pancreatic arteries at pre-operative scans, historically considered by several centers a contraindication for surgery, does not have a negative impact on survival rates after resection.

"This is the only existing nomogram based on pre-operative objective variables able to assess the chance of long-term survival after surgery for PDAC," said Atsushi Oba, MD, PhD, research associate for surgical oncology, University of Colorado Department of Surgery, and lead author of the paper. "Our results suggest that current classifications of resectability on local anatomic and radiologic features should no longer be considered accurate and that more precise prognostic criteria should be defined. The new PDAC nomogram can become a useful tool for patients and counseling physicians in selecting therapy."

The study offers the advantage of estimating the outcome of each patient before an operation, and regardless of local anatomic features of the tumor, to understand if a patient qualifies or not for an operation based on his or her long-term predicted survival. The use of the nomogram in clinical practice should be proposed after a prospective validation.

"These results support the direction we're taking at the University of Colorado Anschutz Medical Campus," said Dr. Richard Schulick, MD, MBA, FACS, Chair of the Department of Surgery and Director of the University of Colorado Cancer Center on the campus. "By providing a multidisciplinary approach to the treatment of pancreatic diseases, we offer patients personalized care and can match candidates with different kinds of therapies that will work best for their individual case. The result is introducing a new concept of prognosis-based staging for patients and the possibility to overcome the old concept and limitations of the anatomical staging of the disease."
-end-
About the University of Colorado Anschutz Medical Campus

The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education, and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes, and two nationally ranked hospitals that treat more than 2 million adult and pediatric patients each year. Innovative, interconnected and highly collaborative, together we deliver life-changing treatments, patient care, professional training, and conduct world-renowned research powered by more than $550 million in research awards. For more information, visit http://www.cuanschutz.edu.

University of Colorado Anschutz Medical Campus

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.