Patel Mausam, Hans Harliv S, Pan Kelsey, Khan Humza, Donath Elie, Caldera Humberto
Department of Medicine, University of Miami/JFK Medical Center Palm Beach Regional GME Consortium, Atlantis, FL.
Am J Clin Oncol. 2018 Dec;41(12):1176-1184. doi: 10.1097/COC.0000000000000447.
Primary pancreatic signet ring cell carcinoma (SRCC) is a rare histologic variant of pancreatic carcinoma. A population-based analysis of pancreatic SRCC was performed to determine the predictive effects of epidemiological factors and treatment interventions on overall survival (OS) and disease-specific survival (DSS).
The Surveillance, Epidemiology, and End Results registry was searched for pancreatic SRCC cases diagnosed between January 1, 1973 and December 31, 2013. Statistical analysis was performed using the Fisher exact test, χ(2) analysis, Kaplan-Meier method, log-rank test, and Cox proportional hazards regression.
The mean age among 497 patients was 66.6 years (SD, 11.9). Most patients were white (82.7%) and male (54.5%). The 1-, 2-, and 5-year OS rates were 17%, 9%, and 4%, respectively, while the corresponding 1-, 2-, and 5-year rates for DSS were 18%, 10%, and 5%, respectively. On univariable analysis; age, site, grade, stage, and treatment were predictive of OS and DSS (P<0.05). On multivariable analysis; radiation improved OS and DSS (adjusted hazard ratio [aHR], 0.592 and 0.589, respectively), pancreatectomy improved OS and DSS (aHR, 0.360 and 0.355, respectively), and combination therapy improved OS and DSS (aHR, 0.295 and 0.286, respectively). Age, site, and stage were also independent predictors of OS and DSS. Subgroup analysis demonstrated treatment to be an independent predictor of OS and DSS in localized/regional disease, in distant disease, and in patients diagnosed between 2000 and 2013.
Age, site, stage, and treatment independently predict OS and DSS in pancreatic SRCC.
原发性胰腺印戒细胞癌（SRCC）是胰腺癌一种罕见的组织学变体。开展了一项基于人群的胰腺SRCC分析，以确定流行病学因素和治疗干预措施对总生存期（OS）和疾病特异性生存期（DSS）的预测作用。
在监测、流行病学和最终结果登记处中搜索1973年1月1日至2013年12月31日期间诊断的胰腺SRCC病例。采用Fisher精确检验、χ²分析、Kaplan-Meier法、对数秩检验和Cox比例风险回归进行统计分析。
497例患者的平均年龄为66.6岁（标准差11.9）。大多数患者为白人（82.7%）且为男性（54.5%）。1年、2年和5年的OS率分别为17%、9%和4%，而DSS的相应1年、2年和5年率分别为18%、10%和5%。单变量分析显示，年龄、部位、分级、分期和治疗对OS和DSS具有预测性（P<0.05）。多变量分析显示，放疗可改善OS和DSS（调整后风险比[aHR]分别为0.592和0.589），胰腺切除术可改善OS和DSS（aHR分别为0.360和0.355），联合治疗可改善OS和DSS（aHR分别为0.295和0.286）。年龄、部位和分期也是OS和DSS的独立预测因素。亚组分析表明，治疗是局限性/区域性疾病、远处疾病以及2000年至2013年期间诊断患者的OS和DSS的独立预测因素。
年龄、部位、分期和治疗可独立预测胰腺SRCC的OS和DSS。
