M0 pancreatic cancer: treatment and prognosis by primary site

Author:

Deng Zhongming1,Zhang Zelin1,Ding Zhenghua1,Cao Ping1

Affiliation:

1. Hubei University of Medicine

Abstract

Abstract Background Pancreatic cancer is very individual and treatment varies from patient to patient. The aim of this study was to evaluate the effects of surgery, radiotherapy and treatment patterns on the risk of death in patients with non-metastatic pancreatic cancer with different primary sites. There have been few studies on the incidence and survival of patients with non-metastatic pancreatic cancer. Our aim was to examine the difference in prognosis between head and body and tail tumors in patients with non-metastatic pancreatic cance. And, the difference of radiotherapy and chemotherapy in different primary sites. Methods A retrospective cohort study of patients with non-metastatic pancreatic cancer between 2004 and 2016 obtained from the SEER database. SPSS software was used for analysis. We use kaplan-Meier method based on logarithmic rank test to estimate survival distribution. COX univariate and multivariate regression analyses were performed with variables such as race, sex, age at diagnosis, stage, surgery, and radiotherapy. A propensity score matching model was used to further validate prognostic factors associated with survival. Results For 5859 M0 pancreatic cancer patients in the SEER database, ancreatic head tumors accounted for 4824 (82.3%) and pancreatic tail tumors accounted for 1034 (17.7%). The incidence of LN + was higher in pancreatic head than in pancreatic bodytail tumors (OR 1.621, 95%CI 1.381–1.917, P < 0.01). 91.0% of pancreatic head tumor patients and 89.2% with pancreatic bodytail tumor patients received chemotherapy. More pancreatic head tumors were treated with radiation (73.3% vs 66%, P < 0.05) than pancreatic bodytail tumros. for pancreatic head tumors, size, Grade amd T stage, LN+, chemotherapy, and radiotherapy are risk factors of survival。However, size, LN+, and chemotherapy showed no association to the prognosis of pancreatic bodytail tumors. Primary site is not an independent risk factor affecting prognosis. We further verified the above conclusion with a 1:1 propensity score matching. Conclusion We found that primary site is not a risk factor for survival of pancreatic cancer patients, but pancreatic head and body tail pancreatic cancer have different characteristics. In addition, the effects of radiation and chemotherapy differed in the two groups.

Publisher

Research Square Platform LLC

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