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Research article

The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study

Weiwei Sheng, Ming Dong, Guosen Wang, Xiaoyang Shi, Wei Gao, Kewei Wang, He Song, Gang Shi, Xiaodong Tan
DOI: 10.21203/rs.2.10889/v2

Abstract

Background: To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8th AJCC stage) that was just applied in clinical practice in 2018. Methods: 351 patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study. Results: Increasing tumor size (P<0.001), T stage (T1+T2 vs T3+T4, P=0.003), frequent postoperative liver metastasis (PLM) (P=0.002) and 8th AJCC stage (IA to VI, P<0.001; I+II vs III+IV, P=0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3cm (P=0.012), 8th AJCC stage (III+IV) (P=0.025) and PLM (P=0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients (P=0.007). Moreover, pbt was an independent unfavorable factor in multivariate analysis (P=0.009). In addition to 8th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients. Conclusion: Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8th AJCC staging system. 8th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.

Keywords
pancreatic head and body-tail cancers, clinical significance, prognosis, 7th and 8th edition of AJCC staging system

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Preprint: Please note that this article has not completed peer review.
Research article

The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study

Weiwei Sheng, Ming Dong, Guosen Wang, Xiaoyang Shi, Wei Gao, Kewei Wang, He Song, Gang Shi, Xiaodong Tan

STATUS: In Review

Comments: 0
PDF Downloads: 0
HTML Views: 1

Integrity Check:

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Abstract

Background: To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8th AJCC stage) that was just applied in clinical practice in 2018. Methods: 351 patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study. Results: Increasing tumor size (P<0.001), T stage (T1+T2 vs T3+T4, P=0.003), frequent postoperative liver metastasis (PLM) (P=0.002) and 8th AJCC stage (IA to VI, P<0.001; I+II vs III+IV, P=0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3cm (P=0.012), 8th AJCC stage (III+IV) (P=0.025) and PLM (P=0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients (P=0.007). Moreover, pbt was an independent unfavorable factor in multivariate analysis (P=0.009). In addition to 8th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients. Conclusion: Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8th AJCC staging system. 8th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.

Figures

Background

Methods

Results

Discussion

Conclusions

Abbreviations

Declarations

References

Tables

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