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Prognostic value of site-specific metastases in pancreatic adenocarcinoma: A Surveillance Epidemiology and End Results database analysis

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World Journal of Gastroenterology 2017年第10期23卷 1872-1880页

作者： Hani Oweira ulf petrausch Daniel Helbling Jan Schmidt Meinrad Mannhart Arianeb Mehrabi Othmar Schob Anwar Giryes Michael Decker Omar Abdel-Rahman Surgical center Zurich-Swiss cancer institute Department of General Visceral and Transplant SurgeryUniversity of Heidelberg Swiss Tumor immunology institute Gastrointestinal Tumor center Zurich Surgical center Zurich-Hirslanden Hospital Zurich Department of Oncology center of Zug Zentrum für integrative Onkologie clinical Oncology Department Faculty of MedicineAin Shams University

AIM To evaluate the prognostic value of site-specific metastases among patients with metastatic pancreaticc arcinoma registered within the Surveillance, Epidemiology and End Results(SEER) *** SEER database(2010-2013) has been queried through SEER*Stat program to determine the presentation, treatment outcomes and prognostic outcomes of metastatic pancreatic adenocarcinoma according to the site of metastasis. In this study, metastatic pancreatic adenocarcinoma patients were classified according to the site of metastases(liver, lung, bone, brain and distant lymph nodes). We utilized chi-square test to compare the clinicopathological characteristics among different sites of metastases. We used Kaplan-Meier analysis and log-rank testing for survival comparisons. We employed Cox proportional model to perform multivariate analyses of the patient population; and accordingly hazard ratios with corresponding 95%CI were generated. Statistical significance was considered if a two-tailed P value < 0.05 was achieved. RESULTS A total of 13233 patients with stage Ⅳ pancreatic cancer and known sites of distant metastases were identified in the period from 2010-2013 and they were included into the current analysis. Patients with isolated distant nodal involvement or lung metastases have better overall and pancreatic cancer-specific survival compared to patients with isolated liver metastases(for overall survival: lung vs liver metastases: P < 0.0001; distant nodal vs liver metastases: P < 0.0001)(for pancreatic cancer-specific survival: lung vs liver metastases: P < 0.0001; distant nodal vs liver metastases: P < 0.0001). Multivariate analysis revealed that age < 65 years, white race, being married, female gender; surgery to the primary tumor and surgery to the metastatic disease were associated with better overall survival and pancreatic cancer-specific *** Pancreatic adenocarcinoma patients with isolated liver metastases have worse outcomes compared to p

关键词：胰腺的癌症肝转移肺转移骨头转移监视传染病学和结束结果数据库

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