TY - JOUR
T1 - Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size
T2 - Positive Implications for Future Targeted Screening
AU - Hur, Chin
AU - Tramontano, Angela C.
AU - Dowling, Emily C.
AU - Brooks, Gabriel A.
AU - Jeon, Alvin
AU - Brugge, William R.
AU - Gazelle, G. Scott
AU - Kong, Chung Yin
AU - Pandharipande, Pari V.
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objectives Pancreatic ductal adenocarcinoma (PDAC) has not experienced a meaningful mortality improvement for the past few decades. Successful screening is difficult to accomplish because most PDACs present late in their natural history, and current interventions have not provided significant benefit. Our goal was to identify determinants of survival for early PDAC to help inform future screening strategies. Methods Early PDACs from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program database (2000-2010) were analyzed. We stratified by size and included carcinomas in situ (Tis). Overall cancer-specific survival was calculated. A Cox proportional hazards model was developed and the significance of key covariates for survival prediction was evaluated. Results A Kaplan-Meier plot demonstrated significant differences in survival by size at diagnosis; these survival benefits persisted after adjustment for key covariates in the Cox proportional hazards analysis. In addition, relatively weaker predictors of worse survival included older age, male sex, black race, nodal involvement, tumor location within the head of the pancreas, and no surgery or radiotherapy. Conclusions For early PDAC, we found tumor size to be the strongest predictor of survival, even after adjustment for other patient characteristics. Our findings suggest that early PDAC detection can have clinical benefit, which has positive implications for future screening strategies.
AB - Objectives Pancreatic ductal adenocarcinoma (PDAC) has not experienced a meaningful mortality improvement for the past few decades. Successful screening is difficult to accomplish because most PDACs present late in their natural history, and current interventions have not provided significant benefit. Our goal was to identify determinants of survival for early PDAC to help inform future screening strategies. Methods Early PDACs from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program database (2000-2010) were analyzed. We stratified by size and included carcinomas in situ (Tis). Overall cancer-specific survival was calculated. A Cox proportional hazards model was developed and the significance of key covariates for survival prediction was evaluated. Results A Kaplan-Meier plot demonstrated significant differences in survival by size at diagnosis; these survival benefits persisted after adjustment for key covariates in the Cox proportional hazards analysis. In addition, relatively weaker predictors of worse survival included older age, male sex, black race, nodal involvement, tumor location within the head of the pancreas, and no surgery or radiotherapy. Conclusions For early PDAC, we found tumor size to be the strongest predictor of survival, even after adjustment for other patient characteristics. Our findings suggest that early PDAC detection can have clinical benefit, which has positive implications for future screening strategies.
KW - SEER registry
KW - adenocarcinoma
KW - pancreas
KW - pancreatic cancer
KW - pancreatic neoplasms
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=84951309710&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000000587
DO - 10.1097/MPA.0000000000000587
M3 - Article
C2 - 26692444
AN - SCOPUS:84951309710
SN - 0885-3177
VL - 45
SP - 1062
EP - 1066
JO - Pancreas
JF - Pancreas
IS - 7
ER -