Clinicopathologic characteristics, laboratory parameters, treatment protocols, and outcomes of pancreatic cancer: a retrospective cohort study of 1433 patients in China

Abstract

ObjectivesThe prognosis of people with pancreatic cancer is extremely unfavorable. However, the prognostic factors remain largely undefined. We aimed to perform comprehensive analyses of clinicopathologic characteristics, laboratory parameters, and treatment protocols for exploring their role as prognostic factors of pancreatic cancer.MethodsPatients diagnosed with pancreatic cancer and hospitalized at the China National Cancer Center between April 2006 and May 2016 were enrolled in this retrospective cohort study. Clinicopathologic characteristics, laboratory parameters, and treatment protocols were compared among patients at different stages of the disease. The association between these factors and overall survival (OS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model.ResultsThe present study included 1,433 consecutive patients with pancreatic cancer. Median OS was 10.6 months (95% confidence interval [CI] 9.8–11.3 months), with 1-, 3-, and 5-year survival rates of 43.7%, 14.8%, and 8.8%, respectively. Cox multivariate analysis findings identified the following factors as independent predictors of OS: gender (female vs male, hazard ratio 0.72, 95% CI [0.54–0.95]); elevated total bilirubin (TBil; 1.82, 1.34–2.47); elevated carbohydrate antigen 19-9 (CA19-9; 1.72, 1.17–2.54); tumor being located in pancreatic body and tail (1.52, 1.10–2.10); advanced T stage (T3-4 vs T1-2, 1.62, 1.15–2.27); lymph node metastasis (1.57, 1.20–2.07); distant metastasis (1.59, 1.12–2.27); the presence of surgical resection (0.53, 0.34–0.81); and the presence of systemic chemotherapy (0.62, 0.45–0.82).ConclusionsBeing male, elevated TBil and carcinoembryonic antigen, tumor being located in pancreatic body and tail, advanced T stage, lymph node and distant metastasis, the absence of surgical resection, and the absence of systematic chemotherapy were associated with worse OS in patients with pancreatic cancer.

Prognostic significance of stem cell/ epithelial-mesenchymal transition markers in periampullary/pancreatic cancers: FGFR1 is a promising prognostic marker

“…The two major findings in this study are, first, FGFR1 could be a promising prognostic marker for periampullary cancers, and second, peritumoral fibrosis was associated with tumor recurrence in periampullary cancer patients. We also confirmed significant relationship between overall survival and previously known clinicopathological prognostic markers, such as age, location, T stage, gross type, size, N stage, M stage, lymphatic invasion, vascular invasion, perineural invasion, histological differentiation, inflammation and the staining pattern of the IHC markers (CK20, CDX2), as described in the literature [1,12].…”

Prognostic Significance of Stem Cell/ Epithelial-Mesenchymal Transition Markers in Periampullary/Pancreatic Cancers: FGFR1 Is A Promising Marker.

“…The two major findings in this study are, first, FGFR1 could be a promising prognostic marker for periampullary cancers, and second, peritumoral fibrosis was associated with tumor recurrence in periampullary cancer patients. We also confirmed significant relationship between overall survival and previously known clinicopathological prognostic markers, such as age, location, T stage, gross type, size, N stage, M stage, lymphatic invasion, vascular invasion, perineural invasion, histological differentiation, inflammation and the staining pattern of the IHC markers (CD20, CDX2), as described in the literature [1,12].…”

Pancreatic Adenocarcinoma in Patients with Type 2 Diabetes: Prognosis and Survival

“…Zhang et al's study explored the effect of hypertension on survival. They found that there was a reduction in short-term survival (p=0.031) [9]. Furthermore, our data heavily supports this, as almost 60% of patients who died had hypertension (p=0.027).…”

“…The risk of postoperative complications for patients with T2DM and pancreatic adenocarcinoma who underwent resection was high in the long term [6]. The short-term outcome was also affected by lower survival [9]. However, our study did not show any survival advantage for patients with or without T2DM (p=0.289).…”