Pancreatic Cancer

Pancreatic cancer is the fourth and fifth leading cause of cancerrelated death in the United States and Japan, respectively. Because of its aggressive growth and early metastatic dissemination, the overall 5-year survival rate for patients with pancreatic cancer remains poor (3- 5%). The mortality rate has not shown any significant improvement for decades. In the light of such poor results, data regarding factors which may influence outcome, are essential also in order to optimize the treatment options for pancreatic cancer patients. Previous studies confirmed that subjects, who show a significant increase of CA19-9 at the time of diagnosis or onset of chemotherapy, present a worse survival if compared to those in which the marker is within normal range. Furthermore, seriate analyses of CA19-9 during chemotherapy represent useful and specific markers of response to the treatment itself. In fact, some studies showed that a reduction of CA19-9 values by more than 20% from baseline levels (or 50% in some series), during gemcitabine-based chemotherapy (after 6-8 weeks of treatment), is a predictor of response as well as a favorable prognostic factor. Another relevant prognostic parameter is the presence of perineural, vascular and lymphatic invasion since angiogenesis and vascular invasion are essential characteristics for tumor growth and dissemination. In general, micro-invasion of perineural and vascular tissues reflects an aggressive cancer phenotype. Perineural invasion, in particular, is considered associated with local recurrence in resected pancreatic cancer and with increasing de-differentiation of pancreatic tumours.

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Last date updated on September, 2024