Disparities in survival by stage after surgery between pancreatic head and body/tail in patients with nonmetastatic pancreatic cancer.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
07
2019
accepted:
03
12
2019
entrez:
20
12
2019
pubmed:
20
12
2019
medline:
2
4
2020
Statut:
epublish
Résumé
The survival of pancreatic cancer patients with lesions in different locations is unclear. In addition, the different surgery types for nonmetastatic pancreatic head cancer (PHC) or body/tail cancer (PBTC) have different prognostic influences. We analyzed the association by stage between tumor location (head vs. body/tail) and survival of nonmetastatic pancreatic cancer patients who underwent surgery. We identified stages I to III pancreatic cancer patients who underwent surgery from 2004 through 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. The adjusted hazard ratio (HR) and 95% confidence interval (CI) for cancer-specific survival (CSS) were obtained using Cox regression. A total of 13517 patients or 86.6% had PHC. PHC patients were more likely to have an advanced tumor stage, higher tumor grade, and more frequent and a higher number of positive lymph nodes compared with PBTC patients. The PHC patients had a worse CSS than PBTC patients (P<0.001) and were predominantly at stage I (P = 0.008) and II (P = 0.004). Multivariate Cox regression analysis showed that PHC was an independent prognostic factor associated with a worse CSS in pancreatic cancer patients (HR 1.132, 95% CI 1.042-1.228, P = 0.003), predominantly at stage II (HR 1.128, 95% CI 1.030-1.235, P = 0.009). At a resectable early stage, the PHC patients had a worse CSS than PBTC patients after surgery. PHC was an independent prognostic factor associated with worse survival in pancreatic cancer patients, predominantly at stage II.
Sections du résumé
BACKGROUND
The survival of pancreatic cancer patients with lesions in different locations is unclear. In addition, the different surgery types for nonmetastatic pancreatic head cancer (PHC) or body/tail cancer (PBTC) have different prognostic influences. We analyzed the association by stage between tumor location (head vs. body/tail) and survival of nonmetastatic pancreatic cancer patients who underwent surgery.
METHODS
We identified stages I to III pancreatic cancer patients who underwent surgery from 2004 through 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. The adjusted hazard ratio (HR) and 95% confidence interval (CI) for cancer-specific survival (CSS) were obtained using Cox regression.
RESULTS
A total of 13517 patients or 86.6% had PHC. PHC patients were more likely to have an advanced tumor stage, higher tumor grade, and more frequent and a higher number of positive lymph nodes compared with PBTC patients. The PHC patients had a worse CSS than PBTC patients (P<0.001) and were predominantly at stage I (P = 0.008) and II (P = 0.004). Multivariate Cox regression analysis showed that PHC was an independent prognostic factor associated with a worse CSS in pancreatic cancer patients (HR 1.132, 95% CI 1.042-1.228, P = 0.003), predominantly at stage II (HR 1.128, 95% CI 1.030-1.235, P = 0.009).
CONCLUSION
At a resectable early stage, the PHC patients had a worse CSS than PBTC patients after surgery. PHC was an independent prognostic factor associated with worse survival in pancreatic cancer patients, predominantly at stage II.
Identifiants
pubmed: 31856205
doi: 10.1371/journal.pone.0226726
pii: PONE-D-19-19763
pmc: PMC6922472
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0226726Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Br J Surg. 2018 Jan;105(2):e183-e191
pubmed: 29341146
Oncotarget. 2017 Feb 28;8(9):15159-15167
pubmed: 28122349
Ann Surg Oncol. 2006 Sep;13(9):1189-200
pubmed: 16955385
Zhonghua Wai Ke Za Zhi. 2007 Jan 1;45(1):30-3
pubmed: 17403286
Semin Oncol. 2015 Feb;42(1):110-22
pubmed: 25726056
HPB (Oxford). 2017 Jan;19(1):10-15
pubmed: 27553838
J Surg Res. 2019 Jul;239:60-66
pubmed: 30802706
Cancer Manag Res. 2018 Jul 05;10:1907-1918
pubmed: 30013397
BMC Surg. 2015 Nov 28;15:123
pubmed: 26615588
Acta Oncol. 2018 Dec;57(12):1655-1662
pubmed: 30264642
Surgery. 2003 May;133(5):521-7
pubmed: 12773980
Pancreas. 1995 Nov;11(4):341-4
pubmed: 8532649
Pancreas. 2018 Sep;47(8):e50-e52
pubmed: 30113430
Pancreas. 2004 Mar;28(2):160-5
pubmed: 15028948
Eur J Surg Oncol. 2017 Apr;43(4):735-742
pubmed: 28131670
CA Cancer J Clin. 2019 Jan;69(1):7-34
pubmed: 30620402
Pancreas. 2010 May;39(4):458-62
pubmed: 19924019
World J Surg. 2016 Sep;40(9):2267-75
pubmed: 27138881
J Gastrointest Surg. 2000 Nov-Dec;4(6):567-79
pubmed: 11307091
HPB (Oxford). 2008;10(5):371-6
pubmed: 18982154
Ann Surg. 1996 May;223(5):506-11; discussion 511-2
pubmed: 8651741
J Gastrointest Surg. 2012 Feb;16(2):376-81
pubmed: 22135126