Early Onset Pancreatic Cancer Clinical Characteristics and Survival Associations by use of the National Cancer Data Base Open Access
Dewey, Betsy (2017)
Abstract
Abstract
Early Onset Pancreatic Cancer: Clinical Characteristics and Survival Associations by use of the National Cancer Data Base
By Betsy Dewey
Background: A scarcity of data exists in younger patient populations with pancreatic ductal adenocarcinoma (PDAC) regarding their overall survival and patient characteristics as compared to typically aged patients with PDAC. This report compares a large cohort of patients with PDAC <=50 years of age compared to patients diagnosed after 50 from the National Cancer Data Base (NCDB) over a 10-year period.
Methods: A retrospective analysis of Continuum of Care (CoC) accredited facilities who report their data to the NCDB identified PDAC cases <=50 years on the date of diagnosis and compared the tumor characteristics and survival associations to PDAC cases diagnosed at >50 years of age, between the years of 2004 through 2014, was performed. Covariates reviewed included demographics, clinical and pathological staging, receipt of surgery, and death or last date of follow-up. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test.
Results: A total of 166,728 PDAC cases were identified for analysis. 13,103 (12.72%) cases were determined early onset pancreatic cancer due to diagnoses before or at the age of 50 years and 153,625 (87.28%) cases diagnosed after the age of 50 years. Age range: 18-90. Men in the sample accounted for 7,615 (58.12%) and 77,686 (50.57%) for early onset and typical onset cases, respectively. Women represented 5,488 (41.88%) and 75,939 (49.43%) for early onset and typical onset cases, respectively. Early onset cases were more frequently diagnosed with late stage PDAC and metastatic disease; however, overall survival was better for the younger patient population compared to the older patient population. For every one-year increase in age, the hazard of death increased by 9.7%. African-Americans, both early onset and typical onset, had worse survival compared whites in both age subgroups.
Conclusions: This is the first study using the NCDB to compare clinical characteristics and survival associations among early onset pancreatic cancer patients. The data suggests that despite being diagnosed with similar advanced stage disease, EOPC patients appear to have better overall survival compared to TOPC, which may reflect other causes of death among older patients. The data also provide evidence that highlights the racial disparity among survival of African-Americans compared to whites.
Table of Contents
Table of Contents
Introduction and Rationale
Problem Statement
Research Question/Hypothesis
Background
Early Onset versus Typical Age of Onset Pancreatic Patients
Methods
National Cancer Database
Study Population
Statistical Analysis
Results
Demographics
Table 1. Characteristics of Pancreatic Ductal Adenocarcinoma by Age of Onset Subgroups, 2004-2014
Hazard Ratio by Age of Onset
Survival by Clinical Stage and Age Subgroups
Survival by Race and Age Subgroups
Survival by Primary Site and Age Subgroups
Survival by Resected Patients and Age Subgroups
Discussion
Conclusion
References
Table 2. Hazard Ratio by Age Subgroups
Figure 1. Overall Survival Among Age Subgroups: Early Onset versus Typical Onset
Figure 2. Stage 2 Survivals by EOPC versus Typical Onset
Figure 3. Stage 3 Survivals by EOPC versus Typical Onset
Figure 4. Survival Curves for Whites by Age Subgroups
Figure 5. Survival Curves for African-Americans by Age Subgroups
Figure 6. Survival Curves for Race by Age Subgroups
Figure 7. Survival for Head of Pancreas Tumor by Age Subgroups:
Figure 8. Resected Patient Survival by Age Subgroups
About this Master's Thesis
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