The anatomic location of pancreatic cancer is a prognostic factor for survival

Avo Artinyan, Perry A. Soriano, Christina Prendergast, Tracey Low, Joshua D.I. Ellenhorn, Joseph Kim

Research output: Contribution to journalArticlepeer-review

170 Scopus citations

Abstract

Background. Pancreatic cancers of the body and tail (BT) appear to have poorer survival compared with head (HD) lesions. We hypothesized that potential disparities in outcome may be related to tumor location. Our objective was to examine the relationship between tumor location and survival. Methods. The Surveillance, Epidemiology, and End Results registry identified 33,752 patients with pancreatic adenocarcinoma and 6443 patients who underwent cancer-directed surgery between 1988 and 2004. Differences in survival and relationships between tumor location and clinical factors were assessed. Multivariate analysis was performed to determine the prognostic significance of tumor location. Results. Median survival for the entire cohort was five months and was significantly lower for BT compared to HD lesions (four vs. six months, p < 0.001). Distant metastases (67% vs. 36%, p < 0.001) were greater and cancer-directed surgery (16% vs. 30%, p < 0.001) was lower for BT tumors. Of 6443 resected patients, HD patients (n = 5118) were younger, had a greater number of harvested lymph nodes, were more likely to be lymph node-positive, and had a higher proportion of T3/T4 lesions. Significant univariate predictors of survival included age, T-stage, number of positive and harvested lymph nodes. On multivariate analysis, BT location was a significant prognostic factor for decreased survival (OR 1.11, 95% CI 1.00-1.23, p = 0.05). Discussion. Pancreatic BT cancers have a lower rate of resectability and poorer overall survival compared to HD lesions. Prospective large-cohort studies may definitively prove that tumor location is a prognostic factor for survival in patients with pancreatic cancer.

Original languageEnglish
Pages (from-to)371-376
Number of pages6
JournalHPB
Volume10
Issue number5
DOIs
StatePublished - 2008

Keywords

  • Pancreatic cancer
  • SEER
  • Tumor location

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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