ISSN: 2148-4902 | E-ISSN: 2536-4553
Factors affecting survival in operated pancreatic cancer: Does tumor localization have a significant effect on treatment outcomes? [North Clin Istanb]
North Clin Istanb. 2020; 7(5): 487-493 | DOI: 10.14744/nci.2020.09735

Factors affecting survival in operated pancreatic cancer: Does tumor localization have a significant effect on treatment outcomes?

Abdullah Sakin1, Suleyman Sahin2, Ayşegül Sakin3, Muhammed Mustafa Atcı4, Serdar Arıcı4, Nurgul Yasar4, Cumhur Demir4, Caglayan Geredeli4, Şener Cihan4
1Department of Medical Oncology, Yuzuncu Yil University Faculty of Medicine, Van, Turkey
2Department of Medical Oncology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
3Department of Internal Medicine, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
4Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey

OBJECTIVE: This study aims to investigate the factors affecting survival in operated pancreatic ductal adenocarcinoma (PDAC) and the possible prognostic effect of primary tumor localization on treatment outcomes.
METHODS: In this study, 98 patients with curatively-operated PDAC, who were followed up and treated for the years 2008 through 2018, were enrolled. Metastatic and locally advanced stages and patients under 18 years of age were excluded from this study. Patients were divided into two groups based on the primary tumor localization as *head or *body/tail.
RESULTS: Sixty-seven (68.3%) patients were male and 31 (31.7%) were female, with a median age of 62 years (range, 35–82 years). The numbers of patients with a primary tumor located in *head vs.*body/tail were 74 (75.4%) vs. 24 (24.6%), respectively. Patients with a primary tumor located in *head vs.*body/tail; median disease-free survival was 16.0 months vs. 13 months (p=0.972), respectively, with corresponding median overall survival was 25 months vs. 33 months (p=0.698). The level of carcinoembryonic antigen(CEA) at diagnosis (Hazard ratio[HR], 1.09 95%CI, 1.01–1.18), stage III disease (HR, 2.09 95%CI, 1.16–4.35), and receiving adjuvant treatment (HR, 0.20 95%CI, 0.09–4.34) were the independent predictors of survival.
CONCLUSION: Our study revealed that high levels of CEA at diagnosis and stage III disease adversely affected the survival in non-metastatic PDAC patients, while receiving adjuvant therapy had a positive effect on survival. The findings suggest that primary tumor localization did not affect survival in operated PC patients. The results on this issue are still inconsistent and under debate in the literature.

Keywords: Pancreas cancer, prognosis; survival; treatment effect; tumor localization.

Opere pankreas kanserinde sağkalımı etkileyen faktörler; Tümör lokalizasyonunun tedavi sonuçları üzerine etkisi var mıdır?

Abdullah Sakin1, Suleyman Sahin2, Ayşegül Sakin3, Muhammed Mustafa Atcı4, Serdar Arıcı4, Nurgul Yasar4, Cumhur Demir4, Caglayan Geredeli4, Şener Cihan4
1Department of Medical Oncology, Yuzuncu Yil University Faculty of Medicine, Van, Turkey
2Department of Medical Oncology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
3Department of Internal Medicine, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
4Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey

Giriş: Bu çalışmada amacımız, opere pankreas duktal adenokarsinomunda (PDAK) sağkalımı etkileyen faktörleri ve primer tümör yerinin tedavi sonuçları üzerindeki olası prognostik etkilerini araştırmaktır.
Materyal ve metod: 2008 - 2018 yılları arasında takip ve tedavi edilen opere PDAK'lu toplam 98 hasta çalışmaya dahil edildi. Metastatik veya lokal ileri evreler ve 18 yaş altı hastalar çalışma dışı bırakıldı. Hastalar primer tümör yerleşimine göre *baş veya *korpus/kuyruk olarak 2 gruba ayrıldı.
Bulgular: Çalışmaya, 66'sı (% 68,3) erkek ve 31'i (% 31,7) kadın olmak üzere toplam 98 hasta alındı. Ortanca yaş 62 yıl (35-82) idi. Primer tümör yerleşimi olarak, 74 (% 75,4) hasta *baş ve 24 (% 24,6) hasta *Korpus/kuyruk lokalize idi. Primer tümör yerleşimine göre *baş lokalize hastalarda ortanca hastalıksız sağkalım, 16,0 ay iken *Korpus/kuyruk lokalize hastalarda 13 aydı (p = 0.972). Ortanca Genel sağkalım ise, *baş lokalize hastalarda 25 ay iken *Korpus/kuyruk lokalize hastalarda 33 aydı (p = 0,698). Çok değikenli analizde tanı sırasındaki karsinoembriyonik antijen(CEA) düzeyi [Tehlike oranı (TO)=1,09 %95 güven aralığı (GA)=1,01-1,18], evre III hastalık (TO=2,09 95% GA=1,16-4,35) ve adjuvan tedavi (TO= 0,20 %95 GA=0,09- 4,34) sağkalımı etkileyen faktörler olarak saptandı.
Tartışma ve sonuç: Çalışmamızda, Opere PDAK tanılı hastalarda, tanı anındaki yüksek CEA düzeyi ve evre III hastalık sağkalımı olumsuz yönde etkilerken, adjuvan tedavi verilmesi sağkalımı arttırdığı gözlendi. Primer tümör yerleşiminin sağkalımı etkilemediği saptandı. (NCI-2019-0345.R1)

Anahtar Kelimeler: pankreas kanseri, tümör yerleşimi, sağkalım, prognoz, tedavi etkisi

Abdullah Sakin, Suleyman Sahin, Ayşegül Sakin, Muhammed Mustafa Atcı, Serdar Arıcı, Nurgul Yasar, Cumhur Demir, Caglayan Geredeli, Şener Cihan. Factors affecting survival in operated pancreatic cancer: Does tumor localization have a significant effect on treatment outcomes?. North Clin Istanb. 2020; 7(5): 487-493

Corresponding Author: Abdullah Sakin
LookUs & Online Makale