Comparisons of Outcomes Between Adolescent and Young Adult with Older Patients After Radical Resection of Pancreatic Ductal Adenocarcinoma by Propensity Score Matching: A Single-Center Study

• Published in: Cancer management and research Vol. 13; pp. 9063 - 9072
• Main Authors: Tang, Neng, Dou, Xiaolin, You, Xing, Liu, Guodong, Ou, Zhenglin, Zai, Hongyan
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Abdomen; Adenocarcinoma; adolescent and young adult (aya); Age groups; Aged patients; Antigens; Body mass index; Cancer; Cardiovascular disease; Chronic obstructive pulmonary disease; Comorbidity; Comparative analysis; Family medical history; Fistula; Hemoglobin; Hospitals; Lymphatic system; Medical prognosis; Medical research; Medicine, Experimental; Mortality; Original Research; overall survival (os); Pancreatic cancer; pancreatic ductal adenocarcinoma (pdac); Pancreaticoduodenectomy; Pancreatitis; Patient outcomes; propensity score matching (psm); Surgery; Teenagers; total pancreaticoduodenectomy (tpd); Tumors; Young adults; Youth; China; United States > US; propensity score matching; PDAC; OS; total pancreaticoduodenectomy; adolescent and young adult; overall survival; AYA; TPD; PSM; pancreatic ductal adenocarcinoma
• ISSN: 1179-1322; 1179-1322
• DOI: 10.2147/CMAR.S337687

Adolescent and young adult (AYA) pancreatic ductal adenocarcinoma (PDAC) occurs in patients below 40 years old. Whether AYA patients have worse outcomes compared with older patients is still controversial. The purpose of this study is to compare the outcomes of AYA patients and older patients after radical surgery for PDAC. A single-center, retrospective, cohort study was conducted in patients who underwent radical surgery for PDAC in Xiangya Hospital Central South University from January 2007 to December 2019. The clinicopathological data and results of patients with PDAC were collected and analyzed retrospectively. They were divided into AYA group and older group based on age (<40, AYA group; ≥40, older group). Based on all the considered covariates except age, we estimated 1:2 case propensity score matching (PSM). A total of 1033 cases were enrolled, 46 cases (4.45%) in the AYA group. Both before and after PSM, the AYA patients have a higher preoperative CA19-9 than the older patients ( < 0.001) and ( < 0.001). Pathological results showed that AYA group had a higher microvascular invasion rate ( < 0.001 and = 0.045) than older group. The median time of overall survival (OS) in AYA group and older group were 13 months (95% = 11.50-14.50) and 14 months (95% = 13.50-14.50), respectively. Additionally, AYA group have a worse 2-year OS rate than older group (8.70% vs 25.23%, = 0.011 and 8.70% vs 25.00%, = 0.023). According to the Log rank test, AYA group have a worse cumulative OS rate than older group ( = 0.002) and ( = 0.030), respectively. PDAC might be more aggressive in AYA, and the cumulative OS after radical PDAC surgery in AYA patients is worse than that in older patients.