Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2023; 15(6): 1178-1190
Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1178
Dissimilar survival and clinicopathological characteristics of mucinous adenocarcinoma located in pancreatic head and body/tail
Zheng Li, Xiao-Jie Zhang, Chong-Yuan Sun, Ze-Feng Li, He Fei, Dong-Bing Zhao
Zheng Li, Xiao-Jie Zhang, Chong-Yuan Sun, Ze-Feng Li, He Fei, Dong-Bing Zhao, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/ National Clinical Research for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Li Z, Zhang XJ and Zhao DB designed research; Sun CY, Fei H and Li Z collected data; Li Z analyzed data; Li Z, Zhang XJ, Fei H, Li Z and Zhao DB wrote the paper; Zhao DB guaranteed integrity of study.
Institutional review board statement: This study was reviewed and approved by the institutional review board of National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Informed consent statement: This was a retrospective, observational cohort study based on publicly accessible database-SEER, therefore informed consent was waived.
Conflict-of-interest statement: The authors have declared that no competing interest exists.
Data sharing statement: The data used is from a publicly accessible database-SEER (www.seer.cancer.gov).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Bing Zhao, MD, Professor, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan South Lane, Chaoyang District, Beijing 100021, China. dbzhao@cicams.ac.cn
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: April 13, 2023
Revised: April 13, 2023
Accepted: April 25, 2023
Article in press: April 25, 2023
Published online: June 27, 2023
Processing time: 94 Days and 8 Hours
ARTICLE HIGHLIGHTS
Research background

Growing evidence shows that pancreatic tumors varied according to different anatomical locations, which produce a significant impact on the prognosis. However, there was no study reported to determine the differences between pancreatic mucinous adenocarcinoma (PMAC) in the head and body/tail of pancreas.

Research motivation

We aimed to investigate the differences in long-term outcomes (overall survival and cancer-specific survival) and clinicopathological characteristics between PMAC in the head and body/tail of pancreas.

Research objectives

A total of 2058 PMAC patients from the Surveillance, Epidemiology, and End Results database diagnosed between 1992 and 2017 were retrospectively reviewed.

Research methods

We divided the patients who met the inclusion criteria into pancreatic head group (PHG) and pancreatic body/tail group (PBTG). The relationship between two groups and risk of invasive factors was identified using logistic regression analysis. Kaplan-Meier analysis and Cox regression analysis were conducted to compare the overall survival (OS) and cancer-specific survival (CSS) of two patient groups.

Research results

After selection, 271 PMAC patients were included in the study. The 1-year, 3-year, and 5-year OS rates of these patients were 51.6%, 23.5%, and 13.6%, respectively. While the 1-year, 3-year, and 5-year CSS rates were 53.2%, 26.2%, and 17.4%, respectively. The median OS of PHG was longer than that of PBTG (18 vs 7.5 mo, P < 0.001). Compared to PHG, patients in PBTG had a greater risk of metastases [odds ratio (OR) = 2.747, 95% confidence interval (CI): 1.628-4.636, P < 0.001] and higher staging (OR = 3.204, 95%CI: 1.895-5.415, P < 0.001). Survival analysis revealed that age < 65 years, male, low-grade (G1-G2), low-stage, systemic therapy, and PMAC located at pancreatic head led to longer OS and CSS (all P < 0.05). The location of PMAC was an independent prognostic factor for CSS [hazard ratio (HR)=0.7, 95%CI: 0.52-0.94, P = 0.017]. Further analysis demonstrated that OS and CSS of PHG were significantly better than PBTG in advanced stage (stage III-IV).

Research conclusions

Compared to pancreatic body/tail, the PMAC located in pancreatic head have a better long-term outcomes and favorable clinicopathological characteristics.

Research perspectives

The new findings may provide novel insights for clinical workers to select appropriate strategies for pancreatic ductal adenocarcinoma management in the future.