Survival Among Pancreaticoduodenectomy Patients Treated for Pancreatic Head Cancer &lt;1 or 2 cm

Franko, Jan; Hugec, Vladimir; Lopes, Thaís Rosental Gabriel; Goldman, Charles D.

doi:10.1245/s10434-012-2621-y

Cited by 22 publications

(17 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A 2013 study of 7,135 patients with pancreatic head cancers treated with pancreaticoduonenectomy by Franco et al (20) demonstrated poorer survival among patients with a larger tumor size compared to those with tumors <1 cm, using a Cox-Proportional Hazard model (HR 1.67, p<0.001; HR 1.18, p=0.15, for >2 cm and 1.1–2 cm, respectively). Their study also showed that N1 nodal status had a significantly worse survival when compared to N0 patients (HR 1.50, p<0.001).…”

Section: Discussionmentioning

confidence: 99%

Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size

et al. 2016

View full text Add to dashboard Cite

Objectives-Pancreatic Ductal AdenoCarcinoma (PDAC) has not experienced a meaningful mortality improvement over the past few decades. Successful screening is difficult to accomplish because most PDACs present late in their natural history, and current interventions have not provided significant benefit. Our goal was to identify determinants of survival for early PDAC to help inform future screening strategies.Methods-Early pancreatic ductal adenocarcinomas from the NCI SEER database (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) were analyzed. We stratified by size and included carcinomas-in-situ (Tis). Overall cancerspecific survival were calculated. A Cox-Proportional Hazards model was developed and the significance of key covariates for survival prediction was evaluated.Results-A Kaplan-Meier plot demonstrated significant differences in survival by size at diagnosis; these survival benefits persisted after adjustment for key covariates in the CoxProportional Hazard analysis. Additional, relatively weaker predictors of worse survival included: older age, male sex, black race, nodal involvement, tumor location within the head of the pancreas, and no surgery or radiotherapy.Conclusions-For early PDAC, we found tumor size to be the strongest predictor of survival, even after adjustment for other patient characteristics. Our findings suggest that early PDAC detection can have clinical benefit, which has positive implications for future screening strategies.

show abstract

Section: Discussionmentioning

confidence: 99%

Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Despite radical surgical resection, survival prognosis remains poor and relapse is common. Long‐term survival (LTS) after PD for PDAC is very rare and cannot be reliably predicted …”

Section: Introductionmentioning

confidence: 99%

Detailed analysis of epithelial‐mesenchymal transition and tumor budding identifies predictors of long‐term survival in pancreatic ductal adenocarcinoma

Kohler

Bronsert

Timme

et al. 2015

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim: Pancreatic ductal adenocarcinoma (PDAC) is characterized by aggressive biology and poor prognosis even after resection. Long-term survival is very rare and cannot be reliably predicted. Experimental data suggest an important role of epithelialmesenchymal transition (EMT) in invasion and metastasis of PDAC. Tumor budding is regarded as the morphological correlate of local invasion and cancer cell dissemination. The aim of this study was to evaluate the biological and prognostic implications of EMT and tumor budding in PDAC of the pancreatic head. Methods: Patients were identified from a prospectively maintained database, and baseline, operative, histopathological, and follow-up data were extracted. Serial tissue slices stained for Pan-Cytokeratin served for analysis of tumor budding, and E-Cadherin, BetaCatenin, and Vimentin staining for analysis of EMT. Baseline, operative, standard pathology, and immunohistochemical parameters were evaluated for prediction of long-term survival (≥ 30 months) in uni-and multivariate analysis. Results: Intra-and intertumoral patterns of EMT marker expression and tumor budding provide evidence of partial EMT induction at the tumor-host interface. Lymph node ratio and E-Cadherin expression in tumor buds were independent predictors of long-term survival in multivariate analysis. Conclusions: Detailed immunohistochemical assessment confirms a relationship between EMT and tumor budding at the tumor-host interface. A small group of patients with favorable prognosis can be identified by combined assessment of lymph node ratio and EMT in tumor buds.

show abstract

“…Tumor size with 3cm and 4 cm cut-offs are not specified in the staging and thus causing conflicts about selection of the tumor size cut-off in defining the tumor stage. 17,47,48 Thus, many studies suggest that 2 cm as cut-off point is not relatively comprehensive and warrants further researches on re-defining or suggesting multiple cut-off points i: e 2 cm, 3cm or 4 cm in order to provide a more comprehensive guideline which accurately explains which tumor stage does tumors with 3 cm and 4 cm belong to and to plan treatment protocol in order to predict the survival outcome following surgery. 17,[48][49][50] Tumor size is undoubtedly an important prognosticator for pancreatic tumor following pancreatic resection.…”

Section: Discussionmentioning

confidence: 99%

“…AJCC classification of tumor size via 2 cm cut-off point is supported by various studies 14,23,32,46,57,58 but also debated by number of studies as the cut-off point being not relatively comprehensive. 17,39,47,48 Currently, there are not adequate literatures that compares survival outcomes with respective tumor size cut-offs like 2 cm, 3 cm and 4 cm. If these sort of studies with more precise sub-division are available in the future than, the tumor stage classified by AJCC can be argued to be changed to a more feasible and effective point that can act as a pivotal reference to new AJCC staging system and thus help to decide in further planning the treatment protocol of the patient and predict survival outcome following surgery.…”

Section: Discussionmentioning

confidence: 99%

Impact of tumor size on survival outcome of pancreatic carcinoma following pancreatic resection: A systematic review and meta-analysis

Shrestha

Baskota

et al. 2018

Asian J Med Sci

View full text Add to dashboard Cite

A B S T R A C T REVIEW ARTICLE ASIAN JOURNAL OF MEDICAL SCIENCESThe aim of the study was to evaluate the influence of tumor size on long-term survival outcome of pancreatic tumors following pancreatic resection and the possibility of implementing another tumor size cut-off point in AJCC pancreatic tumor staging. Literature searches was conducted on electronic database to identify relevant studies on tumor size related survival outcome following pancreatic resection for pancreatic adenocarcinoma. Meta-analysis was done using the effect estimates and the use of 95% confidence intervals (CIs) was done to calculate the pooled risk estimates; heterogeneity among studies was examined using I 2 statistic. Total of 18 trials (13 retrospective and 5 prospective studies) including 6230 elderly patients was included in this study. The pooled HR of the tumor size with 2 cm cut-off was 1.43 with 95% CI of [1.27-1.62], I 2 = 17%, p<0.00001 and was statistically significant. Median survival for tumor size <2, >2, <3, >3, <4 and >4 were 41.02 months, 16.20 months, 19.41 months, 10.79 months, 24.2 months and 15.14 months respectively and the 1-, 3-, and 5-year survival rate decreased with increasing tumor diameter. Importantly, a total of four studies results indicated that 3-year survival rate and a total of five studies results indicated that 5-year survival rate had statistical significance with 3 cm cut-off. Tumor diameter of 2 cm seems to be a reasonable but relatively less comprehensive cut-off point. 3 cm cut-off maybe become a new potential tumor size cut-off point in addition to the current sole 2 cm cut-off point defining tumor stage.

show abstract

Survival Among Pancreaticoduodenectomy Patients Treated for Pancreatic Head Cancer <1 or 2 cm

Abstract: Small pancreatic cancers have a poor prognosis and surprisingly high rate of nodal involvement; therefore, they cannot be considered early cancers. Size-based screening is unlikely to save lives with current treatment options.

Cited by 22 publications

References 26 publications

Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size

Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size

Detailed analysis of epithelial‐mesenchymal transition and tumor budding identifies predictors of long‐term survival in pancreatic ductal adenocarcinoma

Impact of tumor size on survival outcome of pancreatic carcinoma following pancreatic resection: A systematic review and meta-analysis

Contact Info

Product

Resources

About