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Clinical characteristics of second primary pancreatic cancer

Authors
 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 
Citation
 PLOS ONE, Vol.12(6) : e0179784, 2017 
Journal Title
PLOS ONE
Issue Date
2017
MeSH
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
Abstract
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.
Files in This Item:
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DOI
10.1371/journal.pone.0179784
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Hee Seung(이희승) ORCID logo https://orcid.org/0000-0002-2825-3160
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Chung, Jae Bock(정재복)
Cho, In Rae(조인래)
Jo, Jung Hyun(조중현) ORCID logo https://orcid.org/0000-0002-2641-8873
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160286
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