Analysis of prognosis factors in non-functional pancreatic neuroendocrine carcinoma / 国际肿瘤学杂志

ABSTRACT

Objective To investigate the prognosis factors of patients with non-functional pancreatic neuroendocrine carcinoma (NF-PanNEC).Methods The patients with NF-PanNEC confirmed by pathology from 2004 to 2015 were collected from the Surveillance,Epidemiology,and End Results (SEER) database of the American National Cancer Institute.The MatchIt package in the R software was used to perform propensitymatching analysis of surgery,radiotherapy and chemotherapy.The Kaplan-Meier method was used to calculate the cumulative survival rate,and the significant difference was evaluated by the log-rank test.Then the Cox multivariate regression analysis was applied to evaluate the prognostic factors of NF-PanNEC patients.Results A total of 2 603 NF-PanNEC patients were included in the analysis.Univariate analysis showed that the age of diagnosis (x2 =123.8,P ＜ 0.001),gender (x2 =7.3,P =0.007),marital status (x2 =26.7,P ＜ 0.001),primary site of tumor (x2 =47.8,P ＜ 0.001),degree of tumor differentiation (x2 =628.7,P ＜ 0.001),American Joint Committee on Cancer (AJCC) stage (x2 =811.7,P ＜0.001),T stage (x2 =425.9,P ＜ 0.001),N stage (x2 =272.3,P ＜ 0.001),M stage (x2 =779.8,P ＜ 0.001),surgery (x2 =962.6,P ＜ 0.001),chemotherapy (x2 =21.9,P ＜ 0.001) were associated with the prognosis of NF-PanNEC patients.No correlation was observed between radiotherapy and the prognosis of NF-PanNEC patients (x2 =0.1,P =0.750).Multivariate Cox regression analysis showed that older diagnostic age (≥74 years old vs.≤56 years old,HR =2.20,95 ％ CI1.84-2.62,P ＜ 0.001),male (male vs.female,HR =1.14,95 ％ CI为1.01 ～1.29,P =0.035),single or divorced or widowed (single or divorced vs.married,HR =1.26,95 ％ CI1.10-1.45,P =0.001;widowed vs.married,HR =1.29,95％ CI1.04-1.61,P =0.022),head of pancreas (tail of pancreas vs.head of pancreas,HR =0.85,95％ CI0.73-0.99,P =0.033),poor differentiation (grade Ⅳvs.grade Ⅰ,HR=3.75,95％CI2.70-5.20,P＜0.001),late AJCC stage (stage Ⅳ vs.stage Ⅰ,HR =5.72,95％ CI4.23-7.73,P ＜ 0.001),no surgery treatment (yes vs.no,HR =0.37,95％ CI0.30-0.44,P ＜ 0.001) were significant prognostic risk factors for NF-PanNEC patients,and chemotherapy was not independent prognostic factor (yes vs.no,HR=1.00,95％CI0.88-1.13,P=0.958).Conclusion The older diagnostic age,single or divorced or windowed,head of pancreas,poor differentiation,late AJCC stage and no surgery treatment are significant prognostic risk factors for NF-PanNEC patients.Radiotherapy and chemotherapy may not improve the prognosis of NF-PanNEC patients.