Review
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2007; 13(2): 224-227
Published online Jan 14, 2007. doi: 10.3748/wjg.v13.i2.224
Importance of performance status for treatment outcome in advanced pancreatic cancer
Stefan Boeck, Axel Hinke, Ralf Wilkowski, Volker Heinemann
Stefan Boeck, Volker Heinemann, Department of Internal Medicine III, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
Axel Hinke, WISP Research Institute, Karl-Benz-Str. 1, 40764 Langenfeld, Germany
Ralf Wilkowski, Department of Radiooncology, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, Munich 81377, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Volker Heinemann, Department of Internal Medicine III, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, Munich 81377, Germany. volker.heinemann@med.uni-muenchen.de
Telephone: +49-89-70950 Fax: +49-89-70955256
Received: October 31, 2006
Revised: November 14, 2006
Accepted: December 11, 2006
Published online: January 14, 2007
Abstract

Despite progress in the treatment of advanced and metastatic pancreatic cancer (PC), the outcome of this disease remains dismal for the majority of patients. Given the moderate efficacy of treatment, prognostic factors may help to guide treatment decisions. Several trials identified baseline performance status as an important prognostic factor for survival. Unfit patients with a Karnofsky performance status (KPS) below 70% only have a marginal benefit from chemotherapy with gemcitabine (Gem) and may often benefit more from optimal supportive care. Once, however, the decision is taken to apply chemotherapy, KPS may be used to select either mono- or combination chemotherapy. Patients with a good performance status (KPS = 90%-100%) may have a significant and clinically relevant survival benefit from combination chemotherapy. By contrast, patients with a poor performance status (KPS ≤ 80%) have no advantage from intensified therapy and should rather receive single-agent treatment.

Keywords: Chemotherapy; Gemcitabine; Pancreatic cancer; Performance status; Prognostic factor