Features of T1 pancreatic cancer and validation of the eighth edition AJCC staging system definition using a Korean-Japanese joint cohort and the SEER database.

Autor: Kwon W; Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea., Heo JS; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea., Han IW; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea., Kang CM; Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Hwang HK; Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Kim SC; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea., Park SJ; Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, South Korea., Yoon YS; Department of Surgery, Seoul National University Bundang Hospital, Sungnam, South Korea., Kim YH; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Hospital, Daegu, South Korea., Lim CS; Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea., Lee SY; Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, South Korea., Park T; Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea., Takami H; Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Watanabe N; Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Shimizu Y; Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan., Okuno M; Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan., Yamaue H; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Kawai M; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Seiko H; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Nagakawa Y; Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan., Osakabe H; Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan., Sugiura T; Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Japan, Shizuoka, Japan., Toyama H; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Ohtsuka M; Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Unno M; Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan., Endo I; Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Kitago M; Department of Surgery, Keio University School of Medicine, Tokyo, Japan., Jang JY; Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea.
Jazyk: angličtina
Zdroj: Journal of hepato-biliary-pancreatic sciences [J Hepatobiliary Pancreat Sci] 2023 Sep; Vol. 30 (9), pp. 1129-1140. Date of Electronic Publication: 2023 Mar 12.
DOI: 10.1002/jhbp.1316
Abstrakt: Background/purpose: Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition.
Method: Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed. The results were validated using 3092 T1 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database.
Results: The median survival duration of patients was 50 months, and the 5-year survival rate was 45.1%. R0 resection was unachievable in 10.0% of patients, the nodal metastasis rate was 40.0%, and recurrence occurred in 55.2%. The current T1 subcategorization was not feasible for PDAC, tumors with extrapancreatic extension (72.8%) had worse outcomes than those without extrapancreatic extension (median survival 107 vs. 39 months, p < .001). Extrapancreatic extension was an independent prognostic factor whereas the current T1 subcategorization was not. The results of this study were reproducible with data from the SEER database.
Conclusion: Despite its small size, T1 PDAC displayed aggressive behavior warranting active local and systemic treatment. The subcategorization by the eighth edition of the AJCC staging system was not adequate for PDAC, and better subcategorization methods need to be explored. In addition, the role of extrapancreatic extension in the staging system should be reconsidered.
(© 2023 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)
Databáze: MEDLINE
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