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Survival Among Pancreaticoduodenectomy Patients Treated for Pancreatic Head Cancer <1 or 2 cm

  • Healthcare Policy and Outcomes
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Size of primary tumor has implications for staging, imaging, and treatment of pancreatic head carcinomas. Limited data suggest that small tumor size is associated with better survival. The objective of this population study is to analyze characteristics and survival of patients with resected pancreatic head ductal carcinomas sized <1 and 2 cm.

Methods

Analysis of resected invasive pancreatic head ductal carcinomas captured within SEER Program from 1998 to 2008.

Results

A total of 7,135 cases were analyzed with nodal metastases in 31, 55, and 67 % for subcentimeter, 1.1–2 cm, and >2 cm tumors, respectively. Median survival was longest for node-negative tumors (38, 26, 19 months for tumors measuring ≤1, 1.1–2, and >2 cm, respectively; p < 0.001) versus node-positive tumors (18, 19, 14 months, p < 0.001). In multivariate analysis, large tumor size was associated with higher risk of death (hazard ratio (HR) = 1.179 for tumors 1.1–2 cm, p = 0.152; HR = 1.665 for tumors >2 cm, p < 0.001).

Conclusions

Small pancreatic cancers have a poor prognosis and surprisingly high rate of nodal involvement; therefore, they cannot be considered early cancers. Size-based screening is unlikely to save lives with current treatment options.

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Disclosure

There are no financial disclosures from any authors.

Author information

Authors and Affiliations

  1. Mercy Medical Center, Des Moines, IA, USA

    Jan Franko MD, PhD, FACS & Charles D. Goldman MD

  2. Maplewood Cancer Center, Maplewood, MN, USA

    Vladimir Hugec MD

  3. Iowa Digestive Disease Center, Clive, IA, USA

    Tercio L. Lopes MD

Authors
  1. Jan Franko MD, PhD, FACS
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  2. Vladimir Hugec MD
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  3. Tercio L. Lopes MD
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  4. Charles D. Goldman MD
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Corresponding author

Correspondence to Jan Franko MD, PhD, FACS.

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Franko, J., Hugec, V., Lopes, T.L. et al. Survival Among Pancreaticoduodenectomy Patients Treated for Pancreatic Head Cancer <1 or 2 cm. Ann Surg Oncol 20, 357–361 (2013). https://doi.org/10.1245/s10434-012-2621-y

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  • DOI: https://doi.org/10.1245/s10434-012-2621-y

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