The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer

Lee, Mirang; Kwon, Wooil; Kim, Hongbeom; Byun, Yoonhyeong; Han, Youngmin; Kang, Jae Seung; Choi, Yoo Jin

doi:10.3390/cancers12082036

Cited by 15 publications

(13 citation statements)

References 21 publications

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“…The prognosis between head PDAC and body/tail PDAC were extremely controversial. Some studies indicated primary head PDAC has a better prognosis than body/tail PDAC [ 5 , 6 ], while others suggested the opposite outcome in resectable or early advanced PDAC [ 7 , 8 ]. As the comprehensive studies revealed 4 molecular subtypes of PDAC, squamous, pancreatic progenitor, immunogenic, and aberrantly differentiated endocrine exocrine (ADEX), the squamous subtype was associated with a poor prognosis [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The genetic landscape of pancreatic head ductal adenocarcinoma in China and prognosis stratification

et al. 2022

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Background Pancreatic ductal adenocarcinoma (PDAC) is the major subtype of pancreatic cancer and head PDACs show distinct characteristics from body/tail PDACs. With limited studies based on Asian population, the mutational landscape of Asian PDAC remains unclear. Methods One hundred fifty-one Chinese patients with head PDAC were selected and underwent targeted 425-gene sequencing. Genomic alterations, tumor mutational burden, and microsatellite instability were analyzed and compared with a TCGA cohort. Results The genomic landscape of Chinese and Western head PDAC had identical frequently-mutated genes including KRAS, TP53, SMAD4, and CDKN2A. KRAS hotspot in both cohorts was codon 12 but Chinese PDACs containing more G12V but fewer G12R variants. Potentially pathogenic fusions, CHD2-BRAF and KANK1-MET were identified in two KRAS wild-type patients. Serum cancer antigens CA125 and CA19-9 were positively associated with SMAD4 alterations while high CEA was enriched in wild-type CDKN2A subgroup. The probability of vascular invasion was lower in patients with RNF43 alterations. The nomogram developed including histology grade, the mutation status of SMAD4, TGFBR2, and PREX2 could calculate the risk score of prognoses validated by Chinese and TCGA cohort. Conclusions Chinese head PDAC contained more KRAS G12V mutation than Western population. The well-performed nomogram may improve post-operation care in real-world practice.

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Section: Introductionmentioning

confidence: 99%

The genetic landscape of pancreatic head ductal adenocarcinoma in China and prognosis stratification

et al. 2022

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“…The management of pancreatic cancer has evolved over the years to incorporate multidisciplinary care and numerous treatment modalities. Despite the treatment advances, the overall 5‐year survival rate of pancreatic cancer was reported to be 8.1% 2 . Although tumor resection is considered the only curative treatment option, approximately 60% to 80% of pancreatic cancer cases are not candidates for resection because they are already locally advanced or metastatic at the time of diagnosis 3‐5 .…”

Section: Introductionmentioning

confidence: 99%

“…Despite the treatment advances, the overall 5-year survival rate of pancreatic cancer was reported to be 8.1%. 2 Although tumor resection is considered the only curative treatment option, approximately 60% to 80% of pancreatic cancer cases are not candidates for resection because they are already locally advanced or metastatic at the time of diagnosis. [3][4][5] Locally advanced (unresectable) pancreatic cancer (LAPC), which is surgically unresectable due to local involvement of adjacent vessels, accounts for 30% of all newly diagnosed pancreatic cancers.…”

Section: Introductionmentioning

confidence: 99%

Impact of conversion surgery on survival in locally advanced pancreatic cancer patients treated with FOLFIRINOX chemotherapy

Lee

Kang

Kim

et al. 2021

J Hepato Biliary Pancreat

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Background: Locally advanced (unresectable) pancreatic cancer (LAPC) is surgically unresectable and often treated with chemotherapy. Most previous studies, that have evaluated conversion surgery after chemotherapy, included heterogeneous patients and chemotherapy regimens, making it challenging to determine the impact of FOLFIRINOX. The present study evaluated the survival benefit of conversion surgery in patients with LAPC who received FOLFIRINOX chemotherapy, and analyzed the prognostic factors. Methods: Patients with LAPC who received FOLFIRINOX as first-line therapy for at least four cycles were included. During chemotherapy, surgical eligibility was determined based on radiologic and metabolic response to the treatment. Clinicopathologic characteristics were compared between the curative-intent surgery and non-resection groups, and the prognostic factors were analyzed.Results: A total of 279 patients were included. The rates of partial response (PR) and stable disease (SD) were 34.1% and 51.4%, respectively, and 16.8% patients underwent curative-intent surgery. The median survival was significantly longer in the resection group than in the non-resection group (56 vs 21 months, P < .001). In a multivariate analysis, curative-intent surgery (HR 0.260; P < .001) was the most important factor. Conclusions: Conversion surgery after FOLFIRINOX chemotherapy effectivelyrescues patients with LAPC. Patients without progression after FOLFIRINOX could be considered as potential candidates for conversion surgery.

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“…Previous studies have shown the primary tumor location may have a significant impact on prognosis in colorectal and gastric cancer (19,20), whereas its influence in PDAC remains controversial. Some previous studies have demonstrated that differences existed in the biological and oncological behavior and prognosis between head/uncinate and body/tail PC (6,7,(21)(22)(23)(24)(25), while other studies (9,26,27) identified no significant correlation between primary tumor location and OS. Huang et al (27) analyzed 11,837 patients with chemotherapy and surgical resection from five different countries, indicating that tumor location had no influence on survival.…”

Section: Discussionmentioning

confidence: 91%

Construction and Validation of Novel Nomograms for Predicting Prognosis of Pancreatic Ductal Adenocarcinoma After Surgery According to Different Primary Cancer Locations

Liao

Chen

et al. 2021

Front. Oncol.

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Background/AimsPancreatic ductal adenocarcinoma (PDAC) can occur in different parts of the pancreas. This study aimed to identify clinicopathological characteristics independently correlated with the prognosis of PDAC of the pancreatic head/uncinate (PHC) or body-tail (PBTC), and to develop novel nomograms for predicting cancer-specific survival (CSS) according to different primary cancer locations.Methods1160 PDAC patients were retrospectively enrolled and assigned to training and test sets with each set divided into PHC and PBTC groups. Comparative analysis of clinicopathologic characteristics, survival analysis, and multivariate analysis were performed. Independent factors were identified and used for constructing nomograms. The performance of the nomograms was validated in the test set.ResultsPrimary tumor location was an independent risk factor for prognosis of PDAC after surgery. Specially, gender, fasting blood glucose, and preoperative cancer antigen 19-9 were significantly associated with prognosis of PHC, whereas age, body mass index, and lymph nodes were significantly correlated with the prognosis of PBTC. A significant difference in prognosis was found between PHC and PBTC in stage Ia and stage III. Three nomograms were established for predicting the prognosis for PDAC, PHC, and PBTC. Notably, these nomograms were calibrated modestly (c-indexes of 0.690 for PDAC, 0.669 for PHC, and 0.704 for PBTC), presented better accuracy and reliability than the 8th AJCC staging system, and achieved clinical validity.ConclusionsPHC and PBTC share the differential clinical-pathological characteristics and survival. The nomograms show good performance for predicting prognosis in PHC and PBTC. Therefore, these nomograms hold potential as novel approaches for predicting survival of PHC and PBTC patients after surgery.

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The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer

Cited by 15 publications

References 21 publications

The genetic landscape of pancreatic head ductal adenocarcinoma in China and prognosis stratification

The genetic landscape of pancreatic head ductal adenocarcinoma in China and prognosis stratification

Impact of conversion surgery on survival in locally advanced pancreatic cancer patients treated with FOLFIRINOX chemotherapy

Construction and Validation of Novel Nomograms for Predicting Prognosis of Pancreatic Ductal Adenocarcinoma After Surgery According to Different Primary Cancer Locations

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