{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:37:12Z","timestamp":1788827832914,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,4,18]],"date-time":"2015-04-18T00:00:00Z","timestamp":1429315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BC Cancer Foundation"},{"name":"BCCA Gastrointestinal Cancer Outcomes Unit","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Due to differences in natural history and therapy, clinical trials of patients with advanced pancreatic cancer have recently been subdivided into unresectable locally advanced pancreatic cancer (<jats:styled-content style=\"fixed-case\">LAPC<\/jats:styled-content>) and metastatic disease. We aimed to evaluate prognostic factors in <jats:styled-content style=\"fixed-case\">LAPC<\/jats:styled-content> patients who were treated with first\u2010line chemotherapy and describe patterns of disease progression. Patients with <jats:styled-content style=\"fixed-case\">LAPC<\/jats:styled-content> who initiated first\u2010line palliative chemotherapy, 2001\u20132011 at the <jats:styled-content style=\"fixed-case\">BC<\/jats:styled-content> Cancer Agency were included. A retrospective chart review was conducted to identify clinicopathologic variables, treatment, and subsequent sites of metastasis. Kaplan\u2013Meier and Cox\u2010regression survival analyses were performed. A total of 244 patients were included in this study. For the majority of patients (94.3%), first\u2010line therapy was single\u2010agent gemcitabine. About 144 (59%) patients developed distant metastatic disease and the most frequent metastatic sites included peritoneum\/omentum (42.3%), liver (41%), lungs (13.9%), and distant lymph nodes (9%). Median overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) for the entire cohort was 11.7\u00a0months (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 10.6\u201312.8). Development of distant metastases was associated with significantly inferior survival (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 3.56, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.57\u20134.93), as was <jats:styled-content style=\"fixed-case\">ECOG<\/jats:styled-content> 2\/3 versus 0\/1 (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.69, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.28\u20132.23), <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> 19.9\u00a0&gt;\u00a01000 versus \u22641000 (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.59, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.19\u20132.14) and female gender, (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.57, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.19\u20132.08). In this population\u2010based study, 41% of <jats:styled-content style=\"fixed-case\">LAPC<\/jats:styled-content> patients treated with first\u2010line chemotherapy died without evidence of distant metastases. Prognostic factors for <jats:styled-content style=\"fixed-case\">LAPC<\/jats:styled-content> were baseline performance status, elevated <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> 19.9, gender, and development of distant metastasis. Results highlight the heterogeneity of <jats:styled-content style=\"fixed-case\">LAPC<\/jats:styled-content> and the importance of locoregional tumor control.<\/jats:p>","DOI":"10.1002\/cam4.459","type":"journal-article","created":{"date-parts":[[2015,4,18]],"date-time":"2015-04-18T09:33:06Z","timestamp":1429349586000},"page":"1171-1177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":115,"title":["Prognostic factors and sites of metastasis in unresectable locally advanced pancreatic cancer"],"prefix":"10.1002","volume":"4","author":[{"given":"Renata D'Alpino","family":"Peixoto","sequence":"first","affiliation":[{"name":"Division of Medical Oncology University of British Columbia British Columbia Cancer Agency Vancouver British Columbia Canada"},{"name":"Pancreas Centre Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Speers","sequence":"additional","affiliation":[{"name":"Gastrointestinal Cancer Outcomes Unit British Columbia Cancer Agency Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen E.","family":"McGahan","sequence":"additional","affiliation":[{"name":"Cancer Surveillance &amp; Outcomes British Columbia Cancer Agency Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Renouf","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology University of British Columbia British Columbia Cancer Agency Vancouver British Columbia Canada"},{"name":"Pancreas Centre Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"Pancreas Centre Vancouver British Columbia Canada"},{"name":"Department of Pathology and Laboratory Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagen F.","family":"Kennecke","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology University of British Columbia British Columbia Cancer Agency Vancouver British Columbia Canada"},{"name":"Pancreas Centre Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21208"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19951101)76:9<1671::AID-CNCR2820760926>3.0.CO;2-R"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0411-y"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.10.112"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn281"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.8904"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1385\/IJGC:34:2-3:107"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.6.2403"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","DOI":"10.1200\/jco.2013.31.18_suppl.lba4003","article-title":"Comparison of chemoradiotherapy (CRT) and chemotherapy (CT) in patients with a locally advanced pancreatic cancer (LAPC) controlled after 4\u00a0months of gemcitabine with or without erlotinib: Final results of the international phase III LAP 07 study. 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