Comparison of Characteristics and Survival Rates of Resectable Pancreatic Ductal Adenocarcinoma According to Tumor Location

Abstract

Introduction: The impact of tumor location on patient survival in pancreatic ductal adenocarcinoma (PDAC) remains controversial. This study investigated the association between primary tumor location and survival rates for resectable PDAC. Method: We analyzed 2,471 PDAC patients who underwent surgical resection between 2000 and 2018 at a single center. The Kaplan-Meier survival curve and log-rank test were performed to compare overall and disease-free survival rates in patients with pancreatic head cancer (PHC) and those with pancreatic body/tail cancer (PBTC). The Cox proportional hazard model was used to evaluate the association between tumor location and survival as well as the prognostic factors for PDAC. Subgroup analysis was performed according to the TNM staging system. Results: Among the sample, 67.9% had PHC and 32.1% had PBTC. Patients with PHC had worse overall survival (24 months vs. 34 months, p < 0.001) and worse disease-free survival (12 months vs. 18 months, p < 0.001) than those with PBTC. Patients with PHC had worse survival in stage IB (36 months vs. 55 months, p = 0.011) and stage IIB (23 months vs. 31 months, p = 0.003) than those with PBTC. No significant difference was observed for stages IA, IIA, and III. Multivariate analysis showed that CA19-9, mGPS, operation time, adjuvant therapy, differentiation, N stage, lymphovascular invasion, and resection margin were risk factors for poor survival after resection. Conclusions: Patients with PHC had worse overall and disease-free survival than those with PBTC. However, tumor location was not an independent prognostic factor for pancreatic cancer.