Tumor location as an indicator of survival in T1 resectable pancreatic ductal adenocarcinoma: a propensity score-matched analysis
Tumor location as an indicator of survival in T1 resectable pancreatic ductal adenocarcinoma: a propensity score-matched analysis
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DOI：
10.1186/s12876-019-0975-3
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发表时间：
2019-04-24
影响因子：
2.4
通讯作者：
Wu, Heshui
中科院分区：
文献类型：
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作者：
Meng, Zibo;Cao, Mingsi;Wu, Heshui
BackgroundThe最新第8版的AJCC分期系统强调肿瘤大小的重要性，然而，肿瘤位置与肿瘤大小相结合的临床意义仍然unknow.MethodsWe进行了这项研究，以探讨肿瘤位置在T1可切除的胰腺导管腺癌（PDAC）的预后作用。从监测、流行病学和最终结果（SEER）数据库（2004-2014）中选择可切除的PDAC患者进行倾向评分匹配分析。结果8409例患者进入倾向评分匹配分析，最终入选4571例患者。在T1期患者中，胰头肿瘤患者的预后比体/尾肿瘤患者差。多因素分析结果显示胰腺体尾位置是T1期PDAC患者生存率较好的独立指标（危险比，0.69; 95%CI，0.52-0.93; P=0.01）。结论改良分期法能较好地评估患者的生存率。肿瘤位置是T1可切除PDAC患者的良好预后指标。根据肿瘤位置修改T1亚组显示出良好的生存预测效果。
BackgroundThe latest 8th edition of the AJCC staging system emphasizes the importance of tumor size however, the clinical significance of the combination of tumor location with tumor size remains unknown.MethodsWe conducted this study to investigate the prognostic role of tumor location in T1 resectable pancreatic ductal adenocarcinoma (PDAC). Resectable PDAC patients from Surveillance, Epidemiology, and End Results (SEER) database (2004-2014) were selected for the propensity score matching analysis. We used matched cohort to analyze the relationship between clinicopathologic features and survival of patients.ResultEight thousand, four hundred nine patients were included in the propensity score matching analysis and 4571 patients were selected for final analysis. In T1 patients, the patients with pancreatic head tumor had worse prognosis compared to the patients with body/tail tumors. Multivariate analysis result showed that pancreatic body/tail location was an independent indicator for better chances of survival in T1 PDAC patients (hazard ratio, 0.69; 95%CI, 0.52-0.93; P=0.01). The modified staging system was more efficient than the AJCC 8th staging system.ConclusionModified staging system exhibited a good assessment of the survival rate. The tumor location is a good prognostic indicator for T1 resectable PDAC patients. Modification of T1 subgroup according to tumor location exhibited favorable survival prediction effects.