Abstract
ObjectivesThe prognosis of people with pancreatic cancer is extremely unfavorable. However, the prognostic factors remain largely undefined. We aimed to perform comprehensive analyses of clinicopathologic characteristics, laboratory parameters, and treatment protocols for exploring their role as prognostic factors of pancreatic cancer.MethodsPatients diagnosed with pancreatic cancer and hospitalized at the China National Cancer Center between April 2006 and May 2016 were enrolled in this retrospective cohort study. Clinicopathologic characteristics, laboratory parameters, and treatment protocols were compared among patients at different stages of the disease. The association between these factors and overall survival (OS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model.ResultsThe present study included 1,433 consecutive patients with pancreatic cancer. Median OS was 10.6 months (95% confidence interval [CI] 9.8–11.3 months), with 1-, 3-, and 5-year survival rates of 43.7%, 14.8%, and 8.8%, respectively. Cox multivariate analysis findings identified the following factors as independent predictors of OS: gender (female vs male, hazard ratio 0.72, 95% CI [0.54–0.95]); elevated total bilirubin (TBil; 1.82, 1.34–2.47); elevated carbohydrate antigen 19-9 (CA19-9; 1.72, 1.17–2.54); tumor being located in pancreatic body and tail (1.52, 1.10–2.10); advanced T stage (T3-4 vs T1-2, 1.62, 1.15–2.27); lymph node metastasis (1.57, 1.20–2.07); distant metastasis (1.59, 1.12–2.27); the presence of surgical resection (0.53, 0.34–0.81); and the presence of systemic chemotherapy (0.62, 0.45–0.82).ConclusionsBeing male, elevated TBil and carcinoembryonic antigen, tumor being located in pancreatic body and tail, advanced T stage, lymph node and distant metastasis, the absence of surgical resection, and the absence of systematic chemotherapy were associated with worse OS in patients with pancreatic cancer.
Highlights
Pancreatic cancer is the fourth-leading cause of cancer mortality worldwide and is estimated to become the second-leading cause by 2030 (Lucas et al, 2016; Rahib et al, 2014)
Overall cohort characteristics This retrospective cohort consisted of 1,433 pancreatic cancer patients with median follow up period of 6.3 (0–132.0) months
Compared with the other stages, the number of patients with a family history of cancer was lower in stage I or III, and the number of patients with a family history of pancreatic cancer was higher in stage II
Summary
Pancreatic cancer is the fourth-leading cause of cancer mortality worldwide and is estimated to become the second-leading cause by 2030 (Lucas et al, 2016; Rahib et al, 2014). Numerous studies (Jooste et al, 2016; Kozak et al, 2016; Sho et al, 2015; Toriola et al, 2014; Wang et al, 2016; Zhang et al, 2012, 2017) have investigated the prognostic factors of pancreatic cancer. The association of several markers with overall survival (OS) is controversial (Jooste et al, 2016; Kozak et al, 2016; Sho et al, 2015; Toriola et al, 2014; Wang et al, 2016; Zhang et al, 2012, 2017)
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