Treatment patterns and survival outcomes in patients with nonmetastatic early-onset pancreatic cancer  

作　　者：Le-Tian Zhang Ying Zhang Bi-Yang Cao Chen-Chen Wu Jing Wang 

机构地区：[1]Graduate School,Chinese PLA Medical School,Beijing 100853,China [2]Department of Radiation Oncology,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China [3]Department of Internal Medicine,Hospital of University of Science and Technology Beijing,Beijing 100083,China [4]Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China

出　　处：《World Journal of Gastroenterology》2024年第12期1739-1750,共12页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not well-defined.AIM To investigate the treatment patterns and survival outcomes in patients with non-metastatic EOPC.METHODS A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated retrospectively.Overall survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier method.Univariate and multivariate analyses with the Cox proportional hazards model were used to identify prognostic factors.RESULTS With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,respectively.The median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic EOPC.CONCLUSION AT improves postoperative survival in localized patients.Surgery after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.

关 键 词：Pancreatic cancer EARLY-ONSET NON-METASTATIC Multimodal treatment RADIOTHERAPY Overall survival 

分 类 号：R735.9[医药卫生—肿瘤]