ABSTRACT
Objective To study the component ratios of pancreatic carcinoma,and prognosis of patients with the different pathological types.Methods The data of 92 011 pancreatic carcinoma patients who were diagnosed by the definite pathological method from 2004 to 2014 were extracted from the US SEER database.The life table was used to calculate the 1-,3-and 5-year survival rates.The Kaplan-Meier was used to construct the survival curves of the patients.The Cox univariate analysis was applied to evaluate the HR of the different pathological types,and the x2 test and independent sample t-test were used to evaluate the base line data.Results The overall 5-year survival of 92 011 pancreatic carcinoma patients was 7.6％.The median survival time was 8.8 months and the component ratios of the pancreatic ductal adenocarcinoma (PDAC),pancreatic epithelium cancer bedside the PDAC,neuroendocrine tumors,undifferentiated carcinoma,mesenchymal carcinoma and rare cancer unclassified were 85.78％,6.40％,6.67％,0.97％,0.10％ and 0.08％,respectively.The differences were statistically significant between the baseline data such as age,gender,race and position (P ＜ 0.05).The overall 5-year survivals of the PDAC,pancreaticepithelium cancer beside the PDAC,neuroendocrine tumors,undifferentiated carcinoma,mesenchymal carcinoma and rare cancer unclassified were 4.2％,13.4％,49.2％,5.0％,29.2％ and 24.5％,respectively,and the median survival times were 5 months,7 months,58 months,2 months,26 months and 7 months respectively.The distant metastasis rate of neuroendocrine carcinoma was the lowest (35.0％).The undifferentiated carcinoma was the most prone to distant metastases (65.2％).Basically,half of the other types of pancreatic cancer had metastasis at the time of diagnosis.In pancreatic epithelium cancer beside the PDAC,the high to low 5-year survival rates were solid pseudopapillary carcinoma (87.3％),cystadenocarcinoma (36.8％),intraductal papillary mucinous neoplasm (36.5％),acinar cell carcinoma (20.0％),and pancreatic adenocarcinoma mixed with other subtypes (19.7％).The incidence of the other types of pancreatic carcinoma was less than 8％,such as mucinous carcinoma,squamous cell carcinoma,adenosquamous carcinoma and signet ring cell carcinoma.In neuroendocrine tumor,the 5-year survival rate of insulinoma (77.1％) was higher than those of neuroendocrine tumor (malignant) (NET,62.0％) and neuroendocrine carcinoma (NEC,46.5％).Conclusion The prognosis of pancreatic carcinoma was poor,and the pathological types had a significant impact on the prognosis of the patients.
ABSTRACT
Objective To study the survival of patients with pancreatic head carcinoma undergoing surgery,and to evaluate the clinicopathological factors associated with prognosis.Methods The data of 4 814 patients who underwent surgery for pancreatic head carcinoma from 2004 to 2009 were extracted from the US SEER database.The life table was used to calculate the survival rate at 5-years.The Kaplan-meier method was used to construct the survival curves of the patients.The univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.and the univariate analysis was evaluated by the log-rank x2 test.Results The overall 5-year survival of 4 818 pancreatic head carcinoma patients was 16.3％.The median survival was 18.9 months,and the 5-year survival rates of the stage Ⅰ A,Ⅰ B,Ⅱ A,Ⅱ B,Ⅲ and Ⅳ patients were 38.8％,35.3％,21.8％,12.2％,9.1％,and 7.3％,respectively.The difference was statistically significant (x2 =287.702;P ＜ 0.05).The factors including sex,age,years of diagnosis,pathological grading,tumor size,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern (all P ＜ 0.05) influenced the survival rate on univariate analysis.There was no clear correlation between race,number of lymph node examined and prognosis.The factors including sex,age,years of diagnosis,pathological grading,tumor size (AJCC 8th),range,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern (all P ＜ 0.05) were independent prognostic factors on multivariate analysis.Conclusions With the increase of TNM staging,the overall survival of patients with pancreatic head carcinoma undergoing surgery gradually decreased.Factors including sex,age,years of diagnosis,pathological grading,tumor size,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern were independent prognostic factors of overall survival.