胰腺导管腺癌:在一项基于美国人口的综合研究中探索临床病理学趋势和种族差异

Abdul Qahar Khan Yasinzai, Bisma Tareen, Katharine Tracy, Nimra Jamil, Marjan Khan, Hafeez Ullah, Muhammad Raza, Amin Ullah Khan, Dauod Arif, Abdul Waheed, Feroze Sidhwa, Subhasis Misra, Nabin Raj Karki, Nagla Abdel Karim, Ludimila Cavalcante, Asad Ullah
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引用次数: 0

摘要

导言胰腺导管腺癌(PDAC)是一种侵袭性极强的恶性肿瘤,约 50% 的 PDAC 在发病时已发生转移。在这项研究中,我们评估了PDAC的人口统计学、年度趋势分析、种族差异、存活率以及不同治疗方式在局部和转移性疾病中的作用。结果中位年龄为69岁,男性发病率略高(52%),80%的病例为白人。在有数据可查的病例中,43%为III级肿瘤,57%为转移性肿瘤。最常见的转移部位是肝脏(15.7%)。从2000年到2018年,年发病率稳步上升。总体观察(OS)5年生存率为4.4%(95% CI 4.3-4.6%),5年病因特异性生存率(CSS)为5%(95% CI 5.1-5.4%)。采用多模式疗法(化疗、手术和放疗)的 5 年生存率为 22%(95% CI 20.5-22.8%)。黑人的5年CSS为4.7%(95% CI为4.2-5.1%),低于白人的5.3%(95% CI为5.1-5.4%)。多变量分析发现,男性和黑人的预后较差。Kaplan-Meier生存分析发现,在所有三个分期中,多模式疗法的疗效最好。手术联合化疗的总生存率最高。随着PDAC发病率的稳步上升,改进治疗方法对提高这些患者的生存率至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Pancreatic ductal adenocarcinoma: exploring clinicopathological trends and racial disparities in a comprehensive U.S. population-based study

Introduction

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy about 50% of PDAC are metastatic at presentation. In this study, we evaluated PDAC demographics, annual trend analysis, racial disparities, survival rate, and the role of different treatment modalities in localized and metastatic disease.

Methods

A total of 144,824 cases of PDAC were obtained from the SEER database from 2000 to 2018.

Results

The median age was 69 years, with a slightly higher incidence in males (52%) and 80% of all cases were white. Among cases with available data, 43% were grade III tumors and 57% were metastatic. The most common site of metastasis was the liver (15.7%). The annual incidence has increased steadily from 2000 to 2018. The overall observed (OS) 5-year survival rate was 4.4% (95% CI 4.3–4.6%), and 5 years cause-specific survival (CSS) was 5% (95% CI 5.1–5.4%). The 5-year survival with multimodal therapy (chemotherapy, surgery, and radiation) was 22% (95% CI 20.5–22.8%). 5-year CSS for the blacks was lower at 4.7% (95% CI 4.2–5.1%) compared to the whites at 5.3% (95% CI 5.1–5.4%). Multivariate analysis found male gender and black race associated with worse prognosis. Kaplan–Meier survival analysis found multimodal therapy to have the best outcomes in all three stages.

Conclusion

PDAC is an aggressive malignancy with male gender and black race are associated with a poor prognosis. Surgery with chemoradiation was associated with the best overall survival. With steadily increasing rates of PDAC, improved treatment modalities are paramount to improving survival in these patients.

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