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Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value.

Qiu M, Qiu H, Jin Y, Wei X, Zhou Y, Wang Z, Wang D, Ren C, Luo H, Wang F, Zhang D, Wang F, Li Y, Yang D, Xu R - J Cancer (2016)

Bottom Line: The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001.Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients.New diagnostic methods are needed to get the pathologic diagnosis.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.; 2. Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.

ABSTRACT

Purpose: Even with the development of new biopsy methods, diagnosis of pancreatic cancer is sometimes without histological evidence. The aim of our study is to find out the status of pancreatic cancer patients who are diagnosed without pathologic confirm and the prognostic value of pathologic diagnosis.

Methods: We identified 52,759 pancreatic adenocarcinoma patients from the Surveillance, Epidemiology, and End RESULTS (SEER) database. Logistic regression model was used to identify factors relating to no pathologic diagnosis. Multivariable Cox regression model identified potential prognostic factors. All statistical tests were two-sided.

Results: There were 6206 (11.76%) patients without pathologic diagnosis. Older age, reported from nursing/convalescent home/hospice or physician's office/private medical practitioner, early year of diagnosis, larger tumor size, pancreatic head cancer, unmarried patients, uninsured and stage I disease all contributed to no pathologic diagnosis. Median cause specific-survival for patients with and without pathologic diagnosis were 7.72 and 3.52 months, respectively. The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001.

Conclusions: Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients. New diagnostic methods are needed to get the pathologic diagnosis.

No MeSH data available.


Related in: MedlinePlus

Survival difference between patients with and without pathologic diagnosis.
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Figure 1: Survival difference between patients with and without pathologic diagnosis.

Mentions: In this study, 42,888 deaths (81.29 %) were observed including 37,702 (80.99%) in the pathologic diagnosis group and 5,186 (83.56%) in the no pathologic diagnosis group. The median CSS for the whole population was 6.65 months. The 1,2,3,4 and 5 year CSS was 30.8%, 14.1%, 8.9%, 7.0% and 6.0% respectively. Since most of the events happened in the first two years, in Table 3 we listed the median CSS, 1-year and 2-year CSS for patients with different clinicopathologic factors. The median CSS in patients with and without pathologic diagnosis was 7.36 months and 3.73 months (Figure 1), P<0.001. The survival of patients in these two groups crossed over after 40 months. The 1,2,3,4 and 5 year CSS was 33.1%, 15.0%, 9.3%, 7.1% and 6.0% for patients with pathologic diagnosis and 19.2%, 10.3%, 8.2%, 7.6% and 7.1% for those without pathologic diagnosis.


Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value.

Qiu M, Qiu H, Jin Y, Wei X, Zhou Y, Wang Z, Wang D, Ren C, Luo H, Wang F, Zhang D, Wang F, Li Y, Yang D, Xu R - J Cancer (2016)

Survival difference between patients with and without pathologic diagnosis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4829556&req=5

Figure 1: Survival difference between patients with and without pathologic diagnosis.
Mentions: In this study, 42,888 deaths (81.29 %) were observed including 37,702 (80.99%) in the pathologic diagnosis group and 5,186 (83.56%) in the no pathologic diagnosis group. The median CSS for the whole population was 6.65 months. The 1,2,3,4 and 5 year CSS was 30.8%, 14.1%, 8.9%, 7.0% and 6.0% respectively. Since most of the events happened in the first two years, in Table 3 we listed the median CSS, 1-year and 2-year CSS for patients with different clinicopathologic factors. The median CSS in patients with and without pathologic diagnosis was 7.36 months and 3.73 months (Figure 1), P<0.001. The survival of patients in these two groups crossed over after 40 months. The 1,2,3,4 and 5 year CSS was 33.1%, 15.0%, 9.3%, 7.1% and 6.0% for patients with pathologic diagnosis and 19.2%, 10.3%, 8.2%, 7.6% and 7.1% for those without pathologic diagnosis.

Bottom Line: The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001.Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients.New diagnostic methods are needed to get the pathologic diagnosis.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.; 2. Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.

ABSTRACT

Purpose: Even with the development of new biopsy methods, diagnosis of pancreatic cancer is sometimes without histological evidence. The aim of our study is to find out the status of pancreatic cancer patients who are diagnosed without pathologic confirm and the prognostic value of pathologic diagnosis.

Methods: We identified 52,759 pancreatic adenocarcinoma patients from the Surveillance, Epidemiology, and End RESULTS (SEER) database. Logistic regression model was used to identify factors relating to no pathologic diagnosis. Multivariable Cox regression model identified potential prognostic factors. All statistical tests were two-sided.

Results: There were 6206 (11.76%) patients without pathologic diagnosis. Older age, reported from nursing/convalescent home/hospice or physician's office/private medical practitioner, early year of diagnosis, larger tumor size, pancreatic head cancer, unmarried patients, uninsured and stage I disease all contributed to no pathologic diagnosis. Median cause specific-survival for patients with and without pathologic diagnosis were 7.72 and 3.52 months, respectively. The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001.

Conclusions: Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients. New diagnostic methods are needed to get the pathologic diagnosis.

No MeSH data available.


Related in: MedlinePlus