Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2017; 23(15): 2757-2762
Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2757
Outcomes and prognostic factors of patients with stage IB and IIA pancreatic cancer according to the 8th edition American Joint Committee on Cancer criteria
Yang Li, Chuan-Gang Tang, Yu Zhao, Wu-You Cao, Guo-Feng Qu
Yang Li, Department of Hepatobiliary Surgery, Organ Transplantation Center, Tianjin First Center Hospital, Tianjin 300192, China
Chuan-Gang Tang, Guo-Feng Qu, Department of Breast Surgery, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou 221009, Jiangsu Province, China
Yu Zhao, Department of Surgery, Tianjin Second People’s Hospital, Tianjin 300192, China
Wu-You Cao, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Author contributions: Tang CG, Cao WY and Qu GF designed the research and critically revised the manuscript for important intellectual content; Li Y and Zhao Y performed the research, analyzed the data and wrote the paper.
Institutional review board statement: The study has been approved by the Bioethics Committee of the Affiliated Xuzhou Hospital of Medical College of Southeast University, China.
Informed consent statement: All patients from the SEER database have agreed to participate in scientific research.
Conflict-of-interest statement: All authors declare no competing financial interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Guo-Feng Qu, Department of Breast Surgery, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, No.199 South Jiefang Road, Xuzhou 221009, Jiangsu Province, China. lisser_126@sina.com
Telephone: +86-516-83956162
Received: December 15, 2016
Peer-review started: December 18, 2016
First decision: January 19, 2017
Revised: February 9, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: April 21, 2017
Abstract
AIM

To evaluate the changes in the 8th edition American Joint Committee on Cancer (AJCC) for defining stage IB and IIA pancreatic cancer and identify their prognostic factors.

METHODS

Pancreatic cancer patients were selected from the Surveillance Epidemiology and End Results database (1973-2013). The enrolled patients were divided into IB and IIA groups based on tumor size according to the 8th edition AJCC criteria. Clinical characteristics, including age, gender, race, tumor size, primary site, and grade were summarized. Univariate and multivariate analyses were performed to explore the prognostic factors of the IB and IIA stages of pancreatic cancer under new criteria.

RESULTS

A total of 1349 pancreatic cancer patients were included. More patients had stage IB rather than stage IIA. Stage IB tumors (54.85%) were mainly located in the head of the pancreas, while stage IIA tumors were more often located in the tail and head of the pancreas (35.21% and 31.75%, respectively). The survival time of stage IB and IIA patients had no significant difference. Univariate and multivariate analyses indicated that the prognostic factors of survival for stage IB and IIA patients were different. For stage IB patients, age and primary site were the independent prognostic factors; for stage IIA patients, age and grade were the independent prognostic factors. The risk of death was lower among patients aged ≤ 65 years than those aged > 65 years.

CONCLUSION

The prognostic factors for stage IB and IIA patients are different, but age is the independent prognostic factor for all patients. The survival time of stage IB and IIA patients has no significant difference.

Keywords: Pancreatic cancer, Prognostic factor, 8th American Joint Committee on Cancer, TNM, Tumor size

Core tip: The 8th edition American Joint Committee on Cancer TNM criteria for pancreatic cancer emphasize the tumor size cutoff point of 4 cm for the first time. Thus we used the Surveillance Epidemiology and End Results database, a population-based database, to evaluate the new changes in pancreatic cancer staging and the prognostic factors of stage IB and IIA pancreatic cancer.