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Clinical characteristics of second primary pancreatic cancer

 Jung Hyun Jo  ;  In Rae Cho  ;  Jang Han Jung  ;  Hee Seung Lee  ;  Moon Jae Chung  ;  Seungmin Bang  ;  Seung Woo Park  ;  Jae Bock Chun  ;  Si Young Song  ;  Jeong Youp Park 
 PLoS One, Vol.12(6) : e0179784, 2017 
Journal Title
 PLoS One 
Issue Date
Aged ; Carcinoma, Pancreatic Ductal/epidemiology ; Carcinoma, Pancreatic Ductal/mortality ; Carcinoma, Pancreatic Ductal/surgery ; Cohort Studies ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasms, Second Primary/epidemiology ; Neoplasms, Second Primary/mortality ; Neoplasms, Second Primary/surgery ; Pancreatic Neoplasms/epidemiology ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/surgery ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors
PURPOSE: Several studies reported the increased risk of second primary pancreatic ductal adenocarcinoma (2nd PDAC) in cancer survivors. However, data on the characteristics of 2nd PDAC are insufficient. METHODS: This retrospective cohort study included 1759 patients with PDAC. They were classified as having 2nd PDAC or first primary PDAC (1st PDAC) according to a prior diagnosed cancer of different origin, at least 6 months before PDAC diagnosis. RESULTS: There were 110 patients (6.4%) with 2nd PDAC and 1606 (93.6%) patients with 1st PDAC. Patients with 2nd PDAC presented with older age (66.5 vs. 62.2 years, p < 0.001) and higher rate of resectability (26.4% vs. 15.9%, p = 0.004) at diagnosis than those with 1st PDAC. Multivariate analysis without considering resectable status showed that 2nd PDAC (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.56-0.94, p = 0.016) was associated with better overall survival. After adjusting for resectable status, however, 2nd PDAC (HR 0.85, 95% CI 0.66-1.09, p = 0.198) was no longer associated with overall survival. When subgroups were separately analyzed according to initial treatment modality, the effectiveness of surgery and chemotherapy were similar between 2nd and 1st PDAC (33.1 vs. 28.5 months, p = 0.860 and 10.8 vs. 10.7 months, p = 0.952). CONCLUSIONS: The proportion of resectable cases was significantly higher in 2nd PDAC. When surgery with curative aim was possible, the overall survival was increased even in patients with 2nd PDAC. These results suggest the importance of screening for second primary cancer in cancer survivors.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박승우(Park, Seung Woo) ORCID logo https://orcid.org/0000-0001-8230-964X
박정엽(Park, Jeong Youp) ORCID logo https://orcid.org/0000-0003-0110-8606
송시영(Song, Si Young) ORCID logo https://orcid.org/0000-0002-1417-4314
이희승(Lee, Hee Seung) ORCID logo https://orcid.org/0000-0002-2825-3160
정문재(Chung, Moon Jae) ORCID logo https://orcid.org/0000-0002-5920-8549
정재복(Chung, Jae Bock)
조인래(Cho, In Rae)
조중현(Jo, Jung Hyun) ORCID logo https://orcid.org/0000-0002-2641-8873
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