In pancreatic adenocarcinoma, it is believed that patients with proximal tumors (head) have earlier diagnosis and higher survival due to anatomic location compared to patients with distal tumors (body/tail). We hypothesized that differences in tumor biology would contribute to poorer survival in body/tail tumors compared to head tumors when diagnosed at the same stage.
We performed a retrospective chart review on 324 patients with pancreatic adenocarcinoma (236 head and 88 body/tail) diagnosed from 2011-2017. We gathered electronic health records from a single center with a high volume of pancreatic cancer directed surgery. We compared median patient survival from onset of diagnosis based on cancer staging and tumor location.
The overall body/tail cancer survival was significantly less than pancreatic head cancer (11.2 months body/tail compared to 16 months head, p=0.015). When broken down individually by stage at diagnosis or surgery, the survival for body/tail cases was not statistically significant to pancreatic head cases (p>0.05). After adjusting for both stage and surgery, the hazard ratio of body/tail reduced from 1.42 to 0.96.
The overall survival of pancreatic head cancer was significantly higher than that of the body/tail cancer, which was attributed to the head group being diagnosed earlier and/or underwent surgery. The head group’s survival advantage diminishes when corrected by stage and surgery and has a similar survival to the body/tail cancer. This result less likely supports a difference in tumor biology on survival.
Lam, Sophia; Zukas, Randi; Micaily, Ida; and Mallick, Atrayee Basu, "Anatomic location and mortality of pancreatic adenocarcinoma: A single institution study" (2021). Phase 1. Paper 12.