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Are risk factors associated with outcomes in pancreatic cancer?

Wang DS, Wang ZQ, Zhang L, Qiu MZ, Luo HY, Ren C, Zhang DS, Wang FH, Li YH, Xu RH - PLoS ONE (2012)

Bottom Line: HBsAg-positivity and elevated fasting plasma glucose were significantly associated with unfavorable survival though not in the multivariate analysis.The presence of MetS (HR: 1.541, 95% CI: 1.095-2.169, p = 0.013), age ≥65, an elevated CA19-9 baseline level, TNM staging, the type of surgery, the degree of differentiation and chemotherapy were independently associated with overall survival.Patients with MetS demonstrated significantly poorer survival.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Oncology in South China, Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.

ABSTRACT

Background: The development of pancreatic cancer is a process in which genes interact with environmental factors. We performed this study to determine the effects of the ABO blood group, obesity, diabetes mellitus, metabolic syndrome (MetS), smoking, alcohol consumption and hepatitis B viral (HBV) infection on patient survival.

Methods: A total of 488 patients with pancreatic cancer were evaluated.

Result: Patients who presented as chronic carriers of HBV infection were younger at disease onset (p = 0.001) and more predominantly male (p = 0.020) than those never exposed to HBV. Patients with MetS had later disease staging (p = 0.000) and a lower degree of pathological differentiation (p = 0.008) than those without MetS. In a univariate analysis, the ABO blood group, smoking and alcohol consumption were not associated with overall survival. HBsAg-positivity and elevated fasting plasma glucose were significantly associated with unfavorable survival though not in the multivariate analysis. The presence of MetS (HR: 1.541, 95% CI: 1.095-2.169, p = 0.013), age ≥65, an elevated CA19-9 baseline level, TNM staging, the type of surgery, the degree of differentiation and chemotherapy were independently associated with overall survival.

Conclusion: We report, for the first time, that patients with chronic HBV infection may represent a special subtype of pancreatic cancer, who have a younger age of disease onset and male dominancy. Patients with MetS had later disease staging and a poorer histological grade. Patients with MetS demonstrated significantly poorer survival.

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(A) The median age according to hepatitis B viral (HBV) infection status in patients with pancreatic cancer.The boxes represent values between the 25th and 75th percentiles, and the horizontal lines within the boxes indicate the median value. The median age (±standard deviation) of patients with HBsAg-positivity/anti-HBc-positivity was 52.00±11.155 years old, and for those with HBsAg-negativity/anti-HBc-negativity, it was 60.50±10.747 years old (p = 0.001). (B) The association between the presence of metabolic syndrome (MetS) and tumor-node-metastasis (TNM) staging in patients with pancreatic cancer. A total of 66 (90.41%) patients presenting with MetS were stage III or IV compared with 279 (67.23%) patients who did not have MetS (p = 0.000). (C) The association between the presence of metabolic syndrome (MetS) and the degree of histological differentiation in patients with pancreatic cancer. Dedifferentiated histology was more frequent in patients with than without MetS. A total of 38 (73.10%) patients presenting with MetS were poorly differentiated or had mucinous adenocarcinoma compared with 147 (49.80%) patients without MetS (p = 0.008).
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pone-0041984-g002: (A) The median age according to hepatitis B viral (HBV) infection status in patients with pancreatic cancer.The boxes represent values between the 25th and 75th percentiles, and the horizontal lines within the boxes indicate the median value. The median age (±standard deviation) of patients with HBsAg-positivity/anti-HBc-positivity was 52.00±11.155 years old, and for those with HBsAg-negativity/anti-HBc-negativity, it was 60.50±10.747 years old (p = 0.001). (B) The association between the presence of metabolic syndrome (MetS) and tumor-node-metastasis (TNM) staging in patients with pancreatic cancer. A total of 66 (90.41%) patients presenting with MetS were stage III or IV compared with 279 (67.23%) patients who did not have MetS (p = 0.000). (C) The association between the presence of metabolic syndrome (MetS) and the degree of histological differentiation in patients with pancreatic cancer. Dedifferentiated histology was more frequent in patients with than without MetS. A total of 38 (73.10%) patients presenting with MetS were poorly differentiated or had mucinous adenocarcinoma compared with 147 (49.80%) patients without MetS (p = 0.008).

Mentions: The association among the presence of MetS, HBV infection and the clinicopathological parameters of patients with pancreatic cancer are shown in Table 3. Patients who presented as chronic carriers of HBV infection (i.e., HBsAg-positive/anti-HBc–positive) were younger at disease onset and more predominantly male than those never exposed to HBV (i.e., HBsAg-negative/anti-HBc–negative). The median age (±SD) of patients with HBsAg-positivity/anti-HBc-positivity was 52.00±11.155 years old, and for those with HBsAg-negativity/anti-HBc-negativity, it was 60.50±10.747 years old (p = 0.001) (Figure 2a). A total of 53 patients (82.81%) who were chronic carriers of HBV infection were male, and there were only 181 (68.05%) male patients who were never exposed to HBV (p = 0.020). HBV infection was not significantly associated with the other clinicopathological characteristics of patients with pancreatic cancer. Patients who were older than 65 years old more frequently presented with MetS compared with patients who were younger than 65 years old (p = 0.038). Sixty-six (90.41%) patients who presented with MetS were at stage III or IV compared with 279 (67.23%) patients who were not (p = 0.000) (Figure 2b). Patients who presented with MetS had a poorer pathological differentiation grade than those without MetS (p = 0.008) (Figure 2c) (Table 3).


Are risk factors associated with outcomes in pancreatic cancer?

Wang DS, Wang ZQ, Zhang L, Qiu MZ, Luo HY, Ren C, Zhang DS, Wang FH, Li YH, Xu RH - PLoS ONE (2012)

(A) The median age according to hepatitis B viral (HBV) infection status in patients with pancreatic cancer.The boxes represent values between the 25th and 75th percentiles, and the horizontal lines within the boxes indicate the median value. The median age (±standard deviation) of patients with HBsAg-positivity/anti-HBc-positivity was 52.00±11.155 years old, and for those with HBsAg-negativity/anti-HBc-negativity, it was 60.50±10.747 years old (p = 0.001). (B) The association between the presence of metabolic syndrome (MetS) and tumor-node-metastasis (TNM) staging in patients with pancreatic cancer. A total of 66 (90.41%) patients presenting with MetS were stage III or IV compared with 279 (67.23%) patients who did not have MetS (p = 0.000). (C) The association between the presence of metabolic syndrome (MetS) and the degree of histological differentiation in patients with pancreatic cancer. Dedifferentiated histology was more frequent in patients with than without MetS. A total of 38 (73.10%) patients presenting with MetS were poorly differentiated or had mucinous adenocarcinoma compared with 147 (49.80%) patients without MetS (p = 0.008).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3404018&req=5

pone-0041984-g002: (A) The median age according to hepatitis B viral (HBV) infection status in patients with pancreatic cancer.The boxes represent values between the 25th and 75th percentiles, and the horizontal lines within the boxes indicate the median value. The median age (±standard deviation) of patients with HBsAg-positivity/anti-HBc-positivity was 52.00±11.155 years old, and for those with HBsAg-negativity/anti-HBc-negativity, it was 60.50±10.747 years old (p = 0.001). (B) The association between the presence of metabolic syndrome (MetS) and tumor-node-metastasis (TNM) staging in patients with pancreatic cancer. A total of 66 (90.41%) patients presenting with MetS were stage III or IV compared with 279 (67.23%) patients who did not have MetS (p = 0.000). (C) The association between the presence of metabolic syndrome (MetS) and the degree of histological differentiation in patients with pancreatic cancer. Dedifferentiated histology was more frequent in patients with than without MetS. A total of 38 (73.10%) patients presenting with MetS were poorly differentiated or had mucinous adenocarcinoma compared with 147 (49.80%) patients without MetS (p = 0.008).
Mentions: The association among the presence of MetS, HBV infection and the clinicopathological parameters of patients with pancreatic cancer are shown in Table 3. Patients who presented as chronic carriers of HBV infection (i.e., HBsAg-positive/anti-HBc–positive) were younger at disease onset and more predominantly male than those never exposed to HBV (i.e., HBsAg-negative/anti-HBc–negative). The median age (±SD) of patients with HBsAg-positivity/anti-HBc-positivity was 52.00±11.155 years old, and for those with HBsAg-negativity/anti-HBc-negativity, it was 60.50±10.747 years old (p = 0.001) (Figure 2a). A total of 53 patients (82.81%) who were chronic carriers of HBV infection were male, and there were only 181 (68.05%) male patients who were never exposed to HBV (p = 0.020). HBV infection was not significantly associated with the other clinicopathological characteristics of patients with pancreatic cancer. Patients who were older than 65 years old more frequently presented with MetS compared with patients who were younger than 65 years old (p = 0.038). Sixty-six (90.41%) patients who presented with MetS were at stage III or IV compared with 279 (67.23%) patients who were not (p = 0.000) (Figure 2b). Patients who presented with MetS had a poorer pathological differentiation grade than those without MetS (p = 0.008) (Figure 2c) (Table 3).

Bottom Line: HBsAg-positivity and elevated fasting plasma glucose were significantly associated with unfavorable survival though not in the multivariate analysis.The presence of MetS (HR: 1.541, 95% CI: 1.095-2.169, p = 0.013), age ≥65, an elevated CA19-9 baseline level, TNM staging, the type of surgery, the degree of differentiation and chemotherapy were independently associated with overall survival.Patients with MetS demonstrated significantly poorer survival.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Oncology in South China, Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.

ABSTRACT

Background: The development of pancreatic cancer is a process in which genes interact with environmental factors. We performed this study to determine the effects of the ABO blood group, obesity, diabetes mellitus, metabolic syndrome (MetS), smoking, alcohol consumption and hepatitis B viral (HBV) infection on patient survival.

Methods: A total of 488 patients with pancreatic cancer were evaluated.

Result: Patients who presented as chronic carriers of HBV infection were younger at disease onset (p = 0.001) and more predominantly male (p = 0.020) than those never exposed to HBV. Patients with MetS had later disease staging (p = 0.000) and a lower degree of pathological differentiation (p = 0.008) than those without MetS. In a univariate analysis, the ABO blood group, smoking and alcohol consumption were not associated with overall survival. HBsAg-positivity and elevated fasting plasma glucose were significantly associated with unfavorable survival though not in the multivariate analysis. The presence of MetS (HR: 1.541, 95% CI: 1.095-2.169, p = 0.013), age ≥65, an elevated CA19-9 baseline level, TNM staging, the type of surgery, the degree of differentiation and chemotherapy were independently associated with overall survival.

Conclusion: We report, for the first time, that patients with chronic HBV infection may represent a special subtype of pancreatic cancer, who have a younger age of disease onset and male dominancy. Patients with MetS had later disease staging and a poorer histological grade. Patients with MetS demonstrated significantly poorer survival.

Show MeSH
Related in: MedlinePlus