Association of the location of pancreatic ductal adenocarcinoma (head, body, tail) with tumor stage, treatment, and survival: a population-based analysis

Background: The association between pancreatic ductal adenocarcinoma (PDAC) location (head, body, tail) and tumor stage, treatment and overall survival (OS) is unclear. Methods: Patients with PDAC diagnosed between 2005 and 2015 were included from the population-based Netherlands Cancer Registry. Patient, tumor and treatment characteristics were compared with the tumor locations. Multivariable logistic and Cox regression analyses were used. Results: Overall, 19,023 patients were included. PDAC locations were 13,451 (71%) head, 2429 (13%) body and 3143 (16%) tail. Differences were found regarding metastasized disease (head 42%, body 69%, tail 84%, p 4 cm: 21%, 40%, 51%, p p Conclusions: PDAC locations in body and tail are larger, more often metastasized and less often resectable than in the pancreatic head. Whereas survival is similar after resection, survival in metastasized disease is somewhat less for PDAC in the pancreatic body and tail.背景：胰腺导管腺癌（pancreatic ductal adenocarcinoma, PDAC）的发病部位（胰头、胰体、胰尾）与肿瘤分期、治疗方案及总生存期（overall survival, OS）之间的关联尚不明确。 方法：本研究从基于人群的荷兰癌症登记库中纳入2005年至2015年确诊的胰腺导管腺癌患者，按肿瘤发病部位分组，对比不同组别患者、肿瘤及治疗相关特征，并采用多变量logistic回归与Cox回归分析开展统计。 结果：本研究共纳入19023例患者，其中发病部位为胰头者13451例（占71%）、胰体者2429例（占13%）、胰尾者3143例（占16%）。不同部位患者的转移性疾病发生率存在差异：胰头组42%、胰体组69%、胰尾组84%（p值）；肿瘤直径≥4 cm的患者占比分别为21%、40%、51%（p值）。 结论：与胰头部位的胰腺导管腺癌相比，胰体与胰尾部位的肿瘤体积更大、更易发生转移，且可切除率更低。尽管接受手术切除后的患者总生存期相近，但转移性胰腺导管腺癌患者中，胰体及胰尾部位肿瘤患者的总生存期略低于胰头部位患者。