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Aim of the study: Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of the study was to search for prognostic factors for survival in patients with gemcitabine (Gem)-refractory or with gemcitabine and cisplatin (GemCis)-refractory advanced pancreatic cancer. Material and methods: We retrospectively evaluated patients with Gem- or GemCis-refractory advanced pancreatic cancer. Sixteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors. Results: Multivariate analysis included the four prognostic significance factors in univariate analysis. Multivariate analysis showed that liver metastasis and second-line chemotherapy were considered independent prognostic factors for survival. Conclusions: Liver metastasis and second- line chemotherapy were identified as important prognostic factors in advanced pancreatic cancer patients refractory to treatment with Gem or GemCis. This prognostic factors may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment. [ABSTRACT FROM AUTHOR]

Isolated adrenal metastasis from non-small cell lung cancer (NSCLC) is a rare event. Nonsurgical treatment of a solitary adrenal metastasis is associated with poor survival. However, in the aspect of long-term survival, the role of adrenalectomy for isolated metastasis is unclear. Here, we reported our experience with surgical treatment of solitary adrenal metastasis in patients with NSCLC whose primary tumor control were achieved and reviewed current literature. Between the 2001 and 2009, five patients underwent curative adrenalectomy (in 1 patient it was bilateral) for suspected solitary adrenal metastasis after surgical treatment of NSCLC. The pathologic examination confirmed in 3 cases a NSCLC metastasis while in 2 cases it was a benign lesion. In the follow-up period, all of the 3 patients with adrenal metastasis had recurrence of NSCLC. Recurrence was local (in the operated adrenal bed) in 2 patients. Palliative radiotherapy focalized to adrenal bed was given to one of the patient with local recurrence. This patient is currently alive 51 months after the adrenalectomy. The other patient with local recurrence died 24 months after the adrenalectomy. Recurrence was systemic (brain and contralateral adrenal gland) in 1 patient who was treated with contralateral adrenalectomy and surgical resection of the cranial metastasis followed by cranial radiotherapy. The patient who underwent bilateral adrenalectomy for metastatic lung cancer died of wide-spread metastatic disease, 79 months after the adrenalectomy. In conclusion, survival benefit can be obtained after complete resection of isolated adrenal metastasis in patients with NSCLC. Therefore, resection of isolated adrenal metastasis should be considered if the primary NSCLC is resectable. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the impact of accompanying comorbidities on survival in non-small-cell lung carcinoma (NSCLC) patients. A total of 221 patients with stage IIIB- IV NSLC between May 1998 and April 2009 were included. Survival data was analyzed according to age (those younger than 65 and those 65 and older) and Charlson Comorbidity Index (CCI) scores. Eighty-six (39%) patients were aged 65 and older, and the remaining 135 (61%) were younger than 65. In the 65 and over group the median survival of patients was 44 months for CCI Group 0, 16 months for CCI Group 1, 10 months for CCI Group 2, and 10 months for CCI Group 3. For the younger group, the median survival time was 19 months for CCI Group 0, 18 months for CCI Group 1, 11 months for CCI Group 2, and 11 months for CCI Group 3. There were no statistically significant differences in the comorbidity factors regarding survival in the two groups of patients. In conclusion, the frequency of comorbidity factors increased in stage IIIB and IV NSCLC patients as age increased. Although survival in patients with higher CCI scores was shorter, the CCI was not associated with survival for patients having local advanced and metastatic disease; no significant difference was found statistically for these patients. Therefore, these patients need to be managed more thoroughly. [ABSTRACT FROM AUTHOR]

Aim of the Study: Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of the study was to search for prognostic factors for survival in patients with gemcitabine (Gem)-refractory or with gemcitabine and cisplatin (GemCis)-refractory advanced pancreatic cancer., Material and Methods: We retrospectively evaluated patients with Gem- or GemCis-refractory advanced pancreatic cancer. Sixteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors., Results: Multivariate analysis included the four prognostic significance factors in univariate analysis. Multivariate analysis showed that liver metastasis and second-line chemotherapy were considered independent prognostic factors for survival., Conclusions: Liver metastasis and second-line chemotherapy were identified as important prognostic factors in advanced pancreatic cancer patients refractory to treatment with Gem or GemCis. This prognostic factors may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.