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Disparities in survival by stage after surgery between pancreatic head and body/tail in patients with nonmetastatic pancreatic cancer


Autoři: Zhenjiang Zheng aff001;  Mojin Wang aff002;  Chunlu Tan aff001;  Yonghua Chen aff001;  Jie Ping aff003;  Rui Wang aff004;  Xubao Liu aff001
Působiště autorů: Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China aff001;  Department of Gastrointestinal Surgery, Institute of Digestive Surgery and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China aff002;  Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, United States of America aff003;  Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226726

Souhrn

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.

Klíčová slova:

Cancer detection and diagnosis – Surgical and invasive medical procedures – Pancreatic cancer – Surgical oncology – Prognosis – Head and neck tumors – Tumor resection – Pancreatectomy


Zdroje

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69: 7–34. doi: 10.3322/caac.21551 30620402

2. Lau MK, Davila JA, Shaib YH. Incidence and survival of pancreatic head and body and tail cancers: a population-based study in the United States. Pancreas 2010; 39: 458–462. doi: 10.1097/MPA.0b013e3181bd6489 19924019

3. Watanabe I, Sasaki S, Konishi M, Nakagohri T, Inoue K, Oda T, et al. Onset symptoms and tumor locations as prognostic factors of pancreatic cancer. Pancreas 2004; 28: 160–165. doi: 10.1097/00006676-200403000-00007 15028948

4. Wu TC, Shao YF, Shan Y, Wu JX, Zhao P. Surgical effect of malignant tumor of body and tail of the pancreas: compare with pancreatic head cancer. Zhonghua Wai Ke Za Zhi 2007; 45: 30–33. 17403286

5. Artinyan A, Soriano PA, Prendergast C, Low T, Ellenhorn JD, Kim J. The anatomic location of pancreatic cancer is a prognostic factor for survival. HPB (Oxford) 2008; 10: 371–376. doi: 10.1080/13651820802291233 18982154

6. van Erning FN, Mackay TM, van der Geest LGM, Groot Koerkamp B, van Laarhoven HWM, Bonsing BA, et al. Association of the location of pancreatic ductal adenocarcinoma (head, body, tail) with tumor stage, treatment, and survival: a population-based analysis. Acta Oncol 2018; 57: 1655–1662. doi: 10.1080/0284186X.2018.1518593 30264642

7. Ruess DA, Makowiec F, Chikhladze S, Sick O, Riediger H, Hopt UT, et al. The prognostic influence of intrapancreatic tumor location on survival after resection of pancreatic ductal adenocarcinoma. BMC Surg 2015; 15: 123. doi: 10.1186/s12893-015-0110-5 26615588

8. Toomey P, Hernandez J, Golkar F, Ross S, Luberice K, Rosemurgy A. Pancreatic adenocarcinoma: complete tumor extirpation improves survival benefit despite larger tumors for patients who undergo distal pancreatectomy and splenectomy. J Gastrointest Surg 2012; 16: 376–381. doi: 10.1007/s11605-011-1765-6 22135126

9. Wade TP, Virgo KS, Johnson FE. Distal pancreatectomy for cancer: results in U.S. Department of Veterans Affairs hospitals, 1987–1991. Pancreas 1995; 11: 341–344. https://doi.org/10.1097/00006676-199511000-00004 8532649

10. Winer LK, Dhar VK, Wima K, Morris MC, Lee TC, Shah SA, et al. The Impact of Tumor Location on Resection and Survival for Pancreatic Ductal Adenocarcinoma. J Surg Res 2019; 239: 60–66. doi: 10.1016/j.jss.2019.01.061 30802706

11. Schwarz RE, Smith DD. Extent of lymph node retrieval and pancreatic cancer survival: information from a large US population database. Ann Surg Oncol 2006; 13: 1189–1200. doi: 10.1245/s10434-006-9016-x 16955385

12. Ling Q, Xu X, Ye P, Xie H, Gao F, Hu Q, et al. The prognostic relevance of primary tumor location in patients undergoing resection for pancreatic ductal adenocarcinoma. Oncotarget 2017; 8: 15159–15167. doi: 10.18632/oncotarget.14768 28122349

13. Dreyer SB, Jamieson NB, Upstill-Goddard R, Bailey PJ, McKay CJ, Biankin AV, et al. Defining the molecular pathology of pancreatic body and tail adenocarcinoma. Br J Surg 2018; 105: e183–e191. doi: 10.1002/bjs.10772 29341146

14. Sohn TA, Yeo CJ, Cameron JL, Koniaris L, Kaushal S, Abrams RA, et al. Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 2000; 4: 567–579. doi: 10.1016/s1091-255x(00)80105-5 11307091

15. Brennan MF, Moccia RD, Klimstra D. Management of adenocarcinoma of the body and tail of the pancreas. Ann Surg 1996; 223: 506–511; discussion 511–2. doi: 10.1097/00000658-199605000-00006 8651741

16. Strasberg SM, Drebin JA, Linehan D. Radical antegrade modular pancreatosplenectomy. Surgery 2003; 133: 521–527. doi: 10.1067/msy.2003.146 12773980

17. Zhou Y, Shi B, Wu L, Si X. A systematic review of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas. HPB (Oxford) 2017; 19: 10–15. doi: 10.1016/j.hpb.2016.07.014 27553838

18. Parikh PY, Lillemoe KD. Surgical management of pancreatic cancer—distal pancreatectomy. Semin Oncol 2015; 42: 110–122. doi: 10.1053/j.seminoncol.2014.12.010 25726056

19. Abe T, Ohuchida K, Miyasaka Y, Ohtsuka T, Oda Y, Nakamura M. Comparison of Surgical Outcomes Between Radical Antegrade Modular Pancreatosplenectomy (RAMPS) and Standard Retrograde Pancreatosplenectomy (SPRS) for Left-Sided Pancreatic Cancer. World J Surg 2016; 40: 2267–2275. doi: 10.1007/s00268-016-3526-x 27138881

20. Comito T, Cozzi L, Zerbi A, Franzese C, Clerici E, Tozzi A, et al. Clinical results of stereotactic body radiotherapy (SBRT) in the treatment of isolated local recurrence of pancreatic cancer after R0 surgery: A retrospective study. Eur J Surg Oncol 2017; 43:735–742. doi: 10.1016/j.ejso.2016.12.012 28131670

21. Wang L, Cheng CS, Chen L, Chen Z. Benefit from the inclusion of surgery in the treatment of patients with stage III pancreatic cancer: a propensity-adjusted, population-based SEER analysis. Cancer Manag Res 2018; 10: 1907–1918. doi: 10.2147/CMAR.S167103 30013397

22. Mukhija D, DPS S, Khorana AA. Adjuvant Treatment in Potentially Curable Pancreatic Cancer: Need to Include Tumor Location in the Equation. Pancreas 2018; 47(8): e50–e52. doi: 10.1097/MPA.0000000000001125 30113430


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PLOS One


2019 Číslo 12
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