Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis
Background: Current evidence on overall survival (OS) between invasive pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary mucinous neoplasm (IPMN) is limited to single-center reports. We aimed to compare the characteristics, management, and OS of invasive PDAC vs. IPMN using a nationa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/4/1185 |
| _version_ | 1797621888822804480 |
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| author | Ioannis A. Ziogas Salvador Rodriguez Franco Nicholas Schmoke Cheryl Meguid Cassandra Murphy Mohammed Al-Musawi Sophoclis P. Alexopoulos Richard D. Schulick Marco Del Chiaro |
| author_facet | Ioannis A. Ziogas Salvador Rodriguez Franco Nicholas Schmoke Cheryl Meguid Cassandra Murphy Mohammed Al-Musawi Sophoclis P. Alexopoulos Richard D. Schulick Marco Del Chiaro |
| author_sort | Ioannis A. Ziogas |
| collection | DOAJ |
| description | Background: Current evidence on overall survival (OS) between invasive pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary mucinous neoplasm (IPMN) is limited to single-center reports. We aimed to compare the characteristics, management, and OS of invasive PDAC vs. IPMN using a national United States (US) database. Methods: Invasive PDAC or IPMN adult (≥18 years) patients were identified in the National Cancer Database (2004–2016). OS was assessed with the Kaplan–Meier method and the stratified log-rank test. Results: We included 101,190 patients (100,834 PDAC, 356 IPMN). A higher proportion of PDAC vs. IPMN patients had clinical N1 (36.8% vs. 15.7%, <i>p</i> < 0.001) and M1 disease (41.2% vs. 5.9%, <i>p</i> < 0.001). A lower proportion of PDAC patients underwent surgery (25.5% vs. 80.3%, <i>p</i> < 0.001), but a higher proportion received chemotherapy (65.4% vs. 46.1%, <i>p</i> < 0.001) or radiation (25.3% vs. 20.5%, <i>p</i> = 0.04). A higher proportion of surgical patients with PDAC vs. IPMN underwent margin-positive resection (23.0% vs. 14.0%, <i>p</i> = 0.001). The median OS for PDAC vs. IPMN was 8.3 vs. 33.4 months. In the stratified analysis for N0M0 disease, the median OS for PDAC vs. IPMN was 12.8 vs. 43.3 months, for N1M0, it was 11.5 vs. 17.0 months, while for M1, it was 4.0 vs. 7.0 months. In both diagnoses, surgery yielded improved OS, while stratified analysis in the surgical cohort demonstrated similar findings. Conclusions: Invasive PDAC is more aggressive than invasive IPMN, yet in the case of metastasis, OS is equally poor. Excellent long-term OS is achievable with surgical resection in highly selected cases, and efforts should focus on facilitating surgical treatment. |
| first_indexed | 2024-03-11T09:03:24Z |
| format | Article |
| id | doaj.art-cefe73b5396e47aeaeb2e2a8d06f1789 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T09:03:24Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-cefe73b5396e47aeaeb2e2a8d06f17892023-11-16T19:37:25ZengMDPI AGCancers2072-66942023-02-01154118510.3390/cancers15041185Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database AnalysisIoannis A. Ziogas0Salvador Rodriguez Franco1Nicholas Schmoke2Cheryl Meguid3Cassandra Murphy4Mohammed Al-Musawi5Sophoclis P. Alexopoulos6Richard D. Schulick7Marco Del Chiaro8Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADivision of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADivision of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADivision of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADivision of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USAClinical Trials Office, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADivision of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USADivision of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADivision of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USABackground: Current evidence on overall survival (OS) between invasive pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary mucinous neoplasm (IPMN) is limited to single-center reports. We aimed to compare the characteristics, management, and OS of invasive PDAC vs. IPMN using a national United States (US) database. Methods: Invasive PDAC or IPMN adult (≥18 years) patients were identified in the National Cancer Database (2004–2016). OS was assessed with the Kaplan–Meier method and the stratified log-rank test. Results: We included 101,190 patients (100,834 PDAC, 356 IPMN). A higher proportion of PDAC vs. IPMN patients had clinical N1 (36.8% vs. 15.7%, <i>p</i> < 0.001) and M1 disease (41.2% vs. 5.9%, <i>p</i> < 0.001). A lower proportion of PDAC patients underwent surgery (25.5% vs. 80.3%, <i>p</i> < 0.001), but a higher proportion received chemotherapy (65.4% vs. 46.1%, <i>p</i> < 0.001) or radiation (25.3% vs. 20.5%, <i>p</i> = 0.04). A higher proportion of surgical patients with PDAC vs. IPMN underwent margin-positive resection (23.0% vs. 14.0%, <i>p</i> = 0.001). The median OS for PDAC vs. IPMN was 8.3 vs. 33.4 months. In the stratified analysis for N0M0 disease, the median OS for PDAC vs. IPMN was 12.8 vs. 43.3 months, for N1M0, it was 11.5 vs. 17.0 months, while for M1, it was 4.0 vs. 7.0 months. In both diagnoses, surgery yielded improved OS, while stratified analysis in the surgical cohort demonstrated similar findings. Conclusions: Invasive PDAC is more aggressive than invasive IPMN, yet in the case of metastasis, OS is equally poor. Excellent long-term OS is achievable with surgical resection in highly selected cases, and efforts should focus on facilitating surgical treatment.https://www.mdpi.com/2072-6694/15/4/1185pancreatic ductal adenocarcinomaintraductal papillary mucinous neoplasminvasive carcinomaNational Cancer Databasesurvival |
| spellingShingle | Ioannis A. Ziogas Salvador Rodriguez Franco Nicholas Schmoke Cheryl Meguid Cassandra Murphy Mohammed Al-Musawi Sophoclis P. Alexopoulos Richard D. Schulick Marco Del Chiaro Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis Cancers pancreatic ductal adenocarcinoma intraductal papillary mucinous neoplasm invasive carcinoma National Cancer Database survival |
| title | Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis |
| title_full | Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis |
| title_fullStr | Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis |
| title_full_unstemmed | Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis |
| title_short | Comparison of Invasive Pancreatic Ductal Adenocarcinoma versus Intraductal Papillary Mucinous Neoplasm: A National Cancer Database Analysis |
| title_sort | comparison of invasive pancreatic ductal adenocarcinoma versus intraductal papillary mucinous neoplasm a national cancer database analysis |
| topic | pancreatic ductal adenocarcinoma intraductal papillary mucinous neoplasm invasive carcinoma National Cancer Database survival |
| url | https://www.mdpi.com/2072-6694/15/4/1185 |
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