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Features of T1 pancreatic cancer and validation of the eighth edition AJCC staging system definition using a Korean-Japanese joint cohort and the SEER database

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Author(s)
Wooil KwonJin Seok HeoIn Woong HanChang Moo KangHo Kyoung HwangSong Cheol KimSang-Jae ParkYoo-Seok YoonYong Hoon KimChang-Sup LimSeung Yeoun LeeTaesung ParkHideki TakamiNobuyuki WatanabeYasuhiro ShimizuMasataka OkunoHiroki YamaueManabu KawaiHirono SeikoYuichi NagakawaHiroaki OsakabeTeiichi SugiuraHirochika ToyamaMasayuki OhtsukaMichiaki UnnoItaru EndoMinoru KitagoJin-Young Jang
Keimyung Author(s)
Kim, Yong Hoon
Department
Dept. of Surgery (외과학)
Journal Title
J Hepatobiliary Pancreat Sci
Issued Date
2023
Volume
30
Issue
9
Keyword
T1extrapancreatic extensionpancreatic cancerstagesubcategorization
Abstract
Background/purpose:
Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition.

Method:
Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed. The results were validated using 3092 T1 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database.

Results:
The median survival duration of patients was 50 months, and the 5-year survival rate was 45.1%. R0 resection was unachievable in 10.0% of patients, the nodal metastasis rate was 40.0%, and recurrence occurred in 55.2%. The current T1 subcategorization was not feasible for PDAC, tumors with extrapancreatic extension (72.8%) had worse outcomes than those without extrapancreatic extension (median survival 107 vs. 39 months, p < .001). Extrapancreatic extension was an independent prognostic factor whereas the current T1 subcategorization was not. The results of this study were reproducible with data from the SEER database.

Conclusion:
Despite its small size, T1 PDAC displayed aggressive behavior warranting active local and systemic treatment. The subcategorization by the eighth edition of the AJCC staging system was not adequate for PDAC, and better subcategorization methods need to be explored. In addition, the role of extrapancreatic extension in the staging system should be reconsidered.
Keimyung Author(s)(Kor)
김용훈
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1868-6982
Source
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.1316
DOI
10.1002/jhbp.1316
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45107
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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