Introduction
Patients and Methods
Cancer Registry
Study Population
Statistical Analysis
Results
Demographics of Patients with ASC and AC
Adenosquamous | Adenocarcinoma |
p
| |
---|---|---|---|
N, % | 95 (0.39) | 14,746 (59.9) | |
Demographic variables | |||
Age, mean (SD) | 68.5 (11.8) | 68.6 (11.8) | 0.9188 |
Sex, n (%) | 0.1565 | ||
Male | 55 (57.9) | 7,462 (50.6) | |
Female | 40 (42.1) | 7,284 (49.4) | |
Ethnicity, n (%) | 0.3740 | ||
White | 72 (75.8) | 9,760 (66.2) | |
Black | 5 (5.3) | 1,108 (7.5) | |
Hispanic | 11 (11.6) | 2,425 (16.5) | |
Asian | 7 (7.4) | 1,365 (9.3) | |
Other | 0 (0) | 88 (0.6) | |
SES quintile, n (%) | 0.3013 | ||
Lowest | 10 (10.5) | 2,083 (14.1) | |
Second lowest | 22 (23.2) | 2,622 (17.8) | |
Middle | 14 (14.7) | 3,153 (21.4) | |
High | 23 (24.2) | 3,322 (22.5) | |
Highest | 26 (27.4) | 3,566 (24.2) | |
Clinical stage, n (%)a
| 0.6242 | ||
Localized | 8 (8.9) | 976 (7.0) | |
Regional | 34 (37.8) | 4,864 (35.1) | |
Metastatic | 48 (53.3) | 8,029 (57.9) | |
Missing data, n (%)b
| 5 (5.3) | 877 (5.9) | |
Treatment variables | |||
Any surgery, n (%)a
|
<0.0001
a
| ||
Yes | 31 (32.6) | 2,428 (16.5) | |
No | 64 (67.4) | 12,300 (83.5) | |
Missing data, n (%)b
| 0 (0) | 18 (0.1) | |
Any radiation, n (%)a
| 0.1515a
| ||
Yes | 20 (21.1) | 2,310 (15.7) | |
No | 75 | 12,422 (84.3) | |
Missing data, n (%)b
| 0 (0) | 14 (0.1) | |
Any chemotherapy, n (%)a
| 0.6786a
| ||
Yes | 42 (46.2) | 6,296 (44.0) | |
No | 49 (53.8) | 8,016 (56.0) | |
Missing data, n (%)b
| 4 (4.2) | 434 (2.9) | |
Locoregional patients, n evaluated | 42 | 5,838 | |
Onc. resection, n (%) |
0.0004
| ||
Yes | 26 (61.9) | 2,071 (35.6) | |
No | 16 (38.1)c
| 3,750 (64.4) | |
Type of resection, n (%) | 0.1084 | ||
PD | 18 (69.2) | 1,690 (81.6) | |
Distal panc. | 5 (19.2) | 181 (8.7) | |
Total panc. | 3 (11.5) | 200 (9.7) | |
Tumor diam. (mm); mean (SD)a
| 46.3 (19.0) | 33.5 (15.1) |
0.0001
|
Missing data, n (%)b
| 0 (0) | 117 (5.7) | |
Lymph nodes positive, n (%)a
| 0.8562 | ||
Yes | 15 (57.7) | 1,236 (60.2) | |
No | 11 (42.3) | 816 (39.8) | |
Missing data, n (%)b
| 0 (0) | 19 (0.9) | |
Adj. chemotherapy, n (%)a
| 0.9902 | ||
Yes | 13 (52.0) | 1,037 (51.9) | |
No | 12 (48) | 962 (48.1) | |
Missing data, n (%)b
| 1 (3.8) | 72 (3.5) | |
Adj. radiation, n (%) | 0.2876 | ||
Yes | 12 (46.2) | 747 (36.1) | |
No | 14 (53.8) | 1,324 (63.9) | |
Metastatic patients, n evaluated | 46 | 7,832 | |
Pall. chemotherapy, n (%) | 0.2397 | ||
Yes | 24 (52.2) | 3,411 (43.6) | |
No | 22 (47.8) | 4,421 (56.4) |
Treatment Patterns and Pathologic Variables of ASC and AC
Overall Survival of ASC and AC
HR | 95% CI |
p
| |
---|---|---|---|
Histologic subtype | |||
AC | 1.000 (referent) | ||
ASC | 1.091 | 0.870–1.367 | 0.4509 |
Age | 1.010 | 1.009–1.012 |
<0.0001
|
Gender | |||
Male | 1.000 (referent) | ||
Female | 0.951 | 0.918–0.986 |
0.006
|
Ethnicity | |||
Caucasian | 1.000 (referent) | ||
Black | 1.035 | 0.966–1.108 | 0.3290 |
Hispanic | 0.955 | 0.906–1.006 | 0.0802 |
Asian | 0.922 | 0.866–0.981 |
0.0108
|
Socioeconomic status | 0.966 | 0.953–0.980 |
<0.0001
|
Clinical stage | |||
Localized | 1.000 (referent) | ||
Regional | 1.275 | 1.177–1.382 |
<0.0001
|
Metastatic | 2.293 | 2.117–2.484 |
<0.0001
|
Oncologic resection | |||
No | 1.000 (referent) | ||
Yes | 0.444 | 0.419–0.472 |
<0.0001
|
Any radiation | |||
No | 1.000 (referent) | ||
Yes | 0.887 | 0.840–0.936 |
<0.0001
|
Any chemotherapy | |||
No | 1.000 (referent) | ||
Yes | 0.508 | 0.488–0.528 |
<0.0001
|
HR | 95% CI |
p
| |
---|---|---|---|
Histologic subtype | |||
AC | 1.000 (referent) | ||
ASC | 0.886 | 0.530–1.482 | 0.6454 |
Age | 1.008 | 1.003–1.014 |
0.0043
|
Gender | |||
Male | 1.000 (referent) | ||
Female | 0.998 | 0.893–1.116 | 0.9740 |
Ethnicity | |||
Caucasian | 1.000 (referent) | ||
Black | 1.095 | 0.865–1.387 | 0.4514 |
Hispanic | 1.043 | 0.884–1.231 | 0.6150 |
Asian | 1.007 | 0.818–1.241 | 0.9445 |
Socioeconomic status | 0.945 | 0.905–0.987 |
0.0112
|
Clinical stage | |||
Localized | 1.000 (referent) | ||
Regional | 1.300 | 1.067–1.583 |
0.0091
|
Tumor diameter | 1.009 | 1.005–1.012 |
<0.0001
|
Lymphatic involvement | |||
No | 1.000 (referent) | ||
Yes | 1.386 | 1.212–1.585 |
<0.0001
|
Adjuvant radiation | |||
No | 1.000 (referent) | ||
Yes | 0.791 | 0.679–0.922 |
0.0027
|
Adjuvant chemotherapy | |||
No | 1.000 (referent) | ||
Yes | 0.651 | 0.561–0.756 |
<0.0001
|
Favorable Prognostic Factors among Patients with ASC
HR | 95% CI | p | |
---|---|---|---|
Age | 1.012 | 0.986–1.038 | 0.3730 |
Gender | |||
Male | 1.000 (referent) | ||
Female | 0.905 | 0.536–1.528 | 0.7088 |
Ethnicity | |||
Caucasian | 1.000 (referent) | ||
Black | 0.703 | 0.244–2.023 | 0.5135 |
Hispanic | 0.890 | 0.390–2.032 | 0.7815 |
Asian | 0.655 | 0.244–1.755 | 0.3998 |
Socioeconomic status | 0.936 | 0.765–1.145 | 0.5915 |
Clinical stage | |||
Localized | 1.000 (referent) | ||
Regional | 2.717 | 0.781–9.451 | 0.1161 |
Metastatic | 4.690 | 1.445–15.216 |
0.0101
|
Oncologic resection | |||
No | 1.000 (referent) | ||
Yes | 0.369 | 0.183–0.747 |
0.0056
|
Any radiation | |||
No | 1.000 (referent) | ||
Yes | 0.474 | 0.242–0.927 |
0.0292
|
Any chemotherapy | |||
No | 1.000 (referent) | ||
Yes | 0.530 | 0.300–0.935 |
0.0285
|
Discussion
Author (ref.) | Number | Resected, n (%) | Median age (years) | Adjuvant treatment, n
| Median OS resected, months | Median OS unresected, months |
---|---|---|---|---|---|---|
Skafida8
| 1 | 1 (100) | 70 | 1 CTX | 6 | NA |
Lampropoulos9
| 1 | 1 (100) | 72 | 1 CXRT | 24 | NA |
Voong27
| 38 | 38 (100) | 68 | 19 CTX 19 CXRT | 10.9 | NA |
Kobayashi10
| 1 | 0 (0) | 72 | NA | NA | 3 |
Smoot7
| 23 | 12 (52) | 67a
| 5 CXRT | 13.1 | 4.8 |
Hsu5
| 12 | 7 (58) | 71 | 5 CTX | 6.51 | NR |
Jamali11
| 1 | 1 (100) | 75 | 1 CTX | 6 | NA |
Alwaheeb12
| 1 | 1 (100) | 45 | NR | NR | NA |
Inoue13
| 1 | 0 (0) | 61 | NA | NA | 0.83 |
Murakami14
| 2 | 2 (100) | 54 | 1 CTX 1 CXRT | 4.5 | NA |
Rahemtullah28
| 14 | 2 (14) | 70a
| NR | 13 | 4 |
Kardon29
| 25 | 13 (52) | 65a
| 5 CTX | 11.3 | 3.0 |
Yamaue15
| 1 | 1 (100) | 63 | 1 CXRT | 40 | NA |
Yavuz16
| 2 | 2 (100) | 50 | NR | 36, NR | NA |
Komatsuda17
| 1 | 1 (100) | 67 | 0 | 6 | NA |
Aranha18
| 2 | 2 (100) | 57 | 2 CXRT | 13.5 | NA |
Madura2
| 6 | 6 (100) | 64a
| 3 CXRT | 5 | NA |
Nabae19
| 2 | 2 (100) | 67 | 1 RT 1 NR | 6.5 | NA |
Lozano20
| 3 | 2 (67) | 59a
| 3 CXRTb
| NR | NR |
Myung21
| 1 | 1 (100) | 64 | 0 | 4 | NA |
Kuji22
| 1 | 1 (100) | 73 | 0 | 2 | NA |
Campman23
| 1 | 1 (100) | 65 | NR | NR | NA |
Onoda24
| 1 | 1 (100) | 64 | 1 CTX | 3 | NA |
Makiyama25
| 1 | 1 (100) | 58 | 0 | 18 | NA |
Tanaka26
| 1 | 1 (100) | 48 | 1 CTX | 7 | NA |
Motojima30
| 6 | 3 (50) | 67c
| NR | 7 | NR |
Yamaguchi31
| 8 | 8 (100) | 56a
| 0 | 5.5 | NA |