Falkmer, Ursula Gerda Inge

Fristup, C

Hansen, C. P.

Ladekarl, M.

Mortensen, F.V.

Mortensen, M B

Pfeiffer, P

Poulsen, Laurids Østergaard

Rasmussen, Louise Skau

Sall, M

Vittrup, B

Yilmaz, Mette Karen

English

    Aalborg UniversitetThe effect of postoperative gemcitabine on overall survival in an unselected nationalDanish cohort of patients with pancreatic cancer treated with curative resectionRasmussen, Louise Skau; Vittrup, B; Ladekarl, M.; Pfeiffer, P; Yilmaz, Mette Karen; Poulsen,Laurids Østergaard; Hansen, C. P.; Mortensen, M B; Mortensen, F.V.; Sall, M; Falkmer,Ursula Gerda Inge; Fristup, C; Danish Pancreatic Cancer Group; Yilmaz, Mette KarenPublication date:2018Document VersionPublisher's PDF, also known as Version of recordLink to publication from Aalborg UniversityCitation for published version (APA):Rasmussen, L. S., Vittrup, B., Ladekarl, M., Pfeiffer, P., Yilmaz, M. K., Poulsen, L. Ø., Hansen, C. P., Mortensen,M. B., Mortensen, F. V., Sall, M., Falkmer, U. G. I., Fristup, C., Danish Pancreatic Cancer Group, & Yilmaz, M.K. (2018). The effect of postoperative gemcitabine on overall survival in an unselected national Danish cohort ofpatients with pancreatic cancer treated with curative resection. Poster presented at Danske Kræftforskningsdage2018, Odense, Denmark.General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright ownersand it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.            ? Users may download and print one copy of any publication from the public portal for the purpose of private study or research.            ? You may not further distribute the material or use it for any profit-making activity or commercial gain            ? You may freely distribute the URL identifying the publication in the public portal ?Take down policyIf you believe that this document breaches copyright please contact us at vbn@aub.aau.dk providing details, and we will remove access tothe work immediately and investigate your claim.Downloaded from vbn.aau.dk on: November 24, 2020The effect of postoperative gemcitabine on overall survival in an unselected national Danish cohort of patients with pancreatic cancer treated with curative resectionContact:Louise Skau RasmussenMD, Ph.D. student, loskr@rn.dkDepartment of Oncology, Aalborg University Hospital, Denmark CT group NCT group p-valueNo. of patients 409 214Age (mean) Range in years 67 (35-85) 70 (46-86) p<0.01Age groups30-49 18 (5%) 9 (4%) p<0.0150-69 237 (59%) 89 (42%)70- 154 (37%) 116 (54%)GenderFemale 196 (48%) 102 (48%) p=0.61Male 213 (52%) 112 (52%)CharlsonComorbidity Index0 177 (43%) 90 (42%) p=0.331 – 2 151 (37%) 71 (33%)>= 3 81 (20%) 53 (24%)Type of resectionWhipple 291 (71%) 147 (69%) p=0.69Total 67 (16%) 41 (19%)Distal 51 (12%) 26 (12%)Vein resectionNo 339 (83%) 178 (83%) p=0.93Yes 70 (17%) 36 (17%)T-stageT1 14 (3%) 12 (6%) p=0.18T2 53 (13%) 23 (11%)T3 322 (79%) 160 (75%)T4 15 (4%) 13 (6%)Missing 5 (1%) 6 (3%)N-stageN0 119 (29%) 71 (33%) p=0.33N1 280 (68%) 135 (63%)Missing 10 (2%) 8 (4%)AJCC/UICC Ia 12 (3%) 9 (4%) p=0.43Ib 26 (6%) 13 (6%)Iia 81 (20%) 46 (22%)Iib 266 (65%) 125 (58%)III 15 (4%) 13 (6%)Missing 9 (2%) 8 (4%)• Patients in the CT group were significantly younger than patients in the NCT group (p<0.001) (Table 1).• No difference between the groups regarding gender, comorbidity, type of resection, vein resection or T/N/AJCC stage were found (Table 1).Table 1: Data on patients receiving postoperative gemcitabine within 10 weeks after resection (CT group) or not (NCT group)T-stage: Tumor stage, N-stage: Lymph node stage, AJCC/UICC: 7th edition.Figure 1: Kaplan-Meier survival curves showing OS for all patients (top figure) and the subgroup of patients with lymph node metastases (bottom figure) according to postoperative gemcitabine (CT group) and no postoperative chemotherapy (NCT group) within 10 weeks after resectionTable 2: mOS according to postoperative gemcitabine (CT group) and no postoperative chemotherapy (NCT group) within 10 weeks after resection in all patients and in the subgroup of patients with lymph node metastases, as well as 5-year survival rate for all patients (95% CI)• No significant differences in mOS and 5-year survival between the patients in the CT and NCT group were found (Table 2 and Figure 1).CONCLUSIONIn the national Danish cohort of patients with resected PC between 2011 and 2016, the 66% receiving postoperative gemcitabine had a mOS of 24 months and a 5-year survival rate of 22%, which are comparable to the adjuvant gemcitabine arms reported in the RCTs. The subgroup of patients with lymph node metastases treated with postoperative gemcitabine showed significantly better mOS than those not treated.• All patients with a curative resection in Denmark between 2011 and 2016 were identified in the Danish Pancreatic Cancer Database (DPCD). • Data regarding age, gender, comorbidity, type of resection, vein resection, T/N/AJCC stage (Table 1), chemotherapy and clinical follow up were retrieved. • 731 patients with ductal adenocarcinoma were treated with a curative PC resection. • 108 patients were excluded: 30 patients died within 10 weeks postoperatively, 29 patients were treated with other regimens than gemcitabine and 49 patients were treated with preoperative chemotherapy. • Of the remaining 623 patients, 409 (66%) received gemcitabine within 10 weeks after resection, the chemotherapy (CT) group, whereas 214 did not receive CT within 10 weeks, the none-chemotherapy (NCT) group (Table 2).To examine the effect of postoperative gemcitabine treatment on mOS in an unselected national cohort of patients with PC in Denmark during a five year period.BACKGROUNDIn Denmark, approximately 150 patients with pancreatic cancer (PC) undergo curative resection each year. Standard treatment is adjuvant gemcitabine. Randomised clinical trials (RCTs) using gemcitabine have shown a median overall survival (mOS) of 2 years and a 5-year survival rate of 15-20%. The effect of gemcitabine treatment outside trials is less clear. AIMPATIENTS AND METHODSRESULTSn=623Resected PC patients 2011-2016NCTCTTreatment within 10 weeks from resectionClinical follow upn= 21422 (16-26)26 ( 19-34)n = 40924 (21-27)22 (17-27)All patientsmOS (months)5-year survival rate (%)n=13514 (11-17)n=28020 (18-24)Subgroup with lymph node metastases mOS (months)Rasmussen LS1,2, Vittrup B3, Ladekarl M3, Pfeiffer P3, Yilmaz MK1,3, Poulsen LØ1,2, Hansen CP3, Mortensen MB3, Mortensen FV3, Sall M3, Falkmer UG1,2, Fristup C 3 Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Denmark1; Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark2 and on behalf of the Danish Pancreatic Cancer Group3 (DPCG.dk).  • Patients with lymph node metastases showed a significantly better survival for the CT group with a mOS of 20 months versus 14 months in the NCT group (p=0.01) (Table 2 and Figure 1).------ CT group NCT group------ CT group          NCT group

The effect of postoperative gemcitabine on overall survival in an unselected national Danish cohort of patients with pancreatic cancer treated with curative resection

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The effect of postoperative gemcitabine on overall survival in an unselected national Danish cohort of patients with pancreatic cancer treated with curative resection

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