Prognosis of distal pancreatic cancers controlled by stage

• Published in: Experimental and therapeutic medicine Vol. 20; no. 2; pp. 1091 - 1097
• Main Authors: Luo, Guopei, Jin, Kaizhou, Cheng, He, Guo, Meng, Gong, Yitao, Fan, Zhiyao, Yang, Chao, Huang, Qiuyi, Ni, Quanxing, Liu, Chen, Yu, Xianjun
• Format: Journal Article
• Language: English
• Published: Athens Spandidos Publications 01.08.2020; Spandidos Publications UK Ltd; D.A. Spandidos
• Subjects: Analysis; Cancer patients; Chemotherapy; Colorectal cancer; Disease; Embryology; Epidemiology; Head & neck cancer; Histology; Literature reviews; Medical prognosis; Metastasis; Mortality; Pancreatic cancer; Prognosis; Statistical analysis; Survival analysis; Tumors
• ISSN: 1792-0981; 1792-1015
• DOI: 10.3892/etm.2020.8795

Patients with distal (body/tail) pancreatic cancer have been found to present worse outcome than patients with head cancer, which is generally attributed to the great proportion of advanced stages for body/tail cancers upon detection. However, differences in prognosis between head and body/tail pancreatic cancers controlled by stage have not been analyzed in-depth. In this study, differences in prognosis between head and body/tail pancreatic cancers were examined using the Surveillance, Epidemiology, and End Results Program (SEER) (1973-2014 registry, 85,715 cases). We found that patients with body/tail pancreatic cancer had worse prognosis than patients with head cancer for all combined stages [adjusted hazard ratio (HR), 1.03, 95% confidence interval (CI), 1.00-1.05, P=0.025]. Compared with patients with head cancer, patients with body/tail cancer had lower mortality for stage I cancers (HR, 0.85, 95% CI, 0.76-0.94, P=0.001), no difference in mortality for stages II or III (stage II, HR, 1.00, 95% CI, 0.95-1.06, P=0.965; stage III, 0.97, 95% CI, 0.91-1.04, P=0.398), and higher mortality for stage IV (HR, 1.07, 95% CI, 1.04-1.10, P<0.001). In addition, the proportion of body/tail pancreatic cancer increased from 24.9% in 1973 to 36.3% in 2014. Therefore, tumor location of body/tail is an independent adverse prognostic factor for patients with pancreatic cancer. However, this observation is not applicable when controlled by stage (body/tail versus head pancreatic cancer, better stage I, similar stage II/III, and worse stage IV). Key words: pancreatic adenocarcinoma, location, prognosis, incidence, outcome