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World J Gastroenterol. 2015 Dec 28;21(48):13574-81. doi: 10.3748/wjg.v21.i48.13574.

Rare long-term survivors of pancreatic adenocarcinoma without curative resection.

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Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.


Long-term outcome data in pancreatic adenocarcinoma are predominantly based on surgical series, as resection is currently considered essential for long-term survival. In contrast, five-year survival in non-resected patients has rarely been reported. In this report, we examined the incidence and natural history of ≥ 5-year survivors with non-resected pancreatic adenocarcinoma. All patients with pancreatic adenocarcinoma who received oncologic therapy alone without surgery at our institution between 1995 and 2009 were identified. Non-resected ≥ 5-year survivors represented 2% (11/544) of all non-resected patients undergoing treatment for pancreatic adenocarcinoma, and 11% (11/98) of ≥ 5-year survivors. Nine patients had localized tumor and 2 metastatic disease at initial diagnosis. Disease progression occurred in 6 patients, and the local tumor bed was the most common site of progression. Six patients suffered from significant morbidities including recurrent cholangitis, second malignancy, malnutrition and bowel perforation. A rare subset of patients with pancreatic cancer achieve long-term survival without resection. Despite prolonged survival, morbidities unrelated to the primary cancer were frequently encountered and a close follow-up is warranted in these patients. Factors such as tumor biology and host immunity may play a key role in disease progression and survival.


5-year survival; Chemotherapy; Cholangitis; Long-term survival; Malnutrition; Non-resected pancreatic cancer; Second malignancy

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