Adjuvant radiotherapy in the treatment of invasive intraductal papillary mucinous neoplasm of the pancreas: an analysis of the surveillance, epidemiology, and end results registry.

Worni, M

Akushevich, I

Gloor, B

Scarborough, J

Chino, JP

Jacobs, DO

Hahn, SM

Clary, BM

Pietrobon, R

Shah, A

United States

2017-06-06T15:27:31Z

2017-06-06T15:27:31Z

2012-04

BACKGROUND: Management and outcomes of patients with invasive intraductal papillary mucinous neoplasm (IPMN) of the pancreas are not well established. We investigated whether adjuvant radiotherapy (RT) improved cancer-specific survival (CSS) and overall survival (OS) among patients undergoing surgical resection for invasive IPMN. METHODS: The Surveillance, Epidemiology, and End Results (SEER) registry was used in this retrospective cohort study. All adult patients with resection of invasive IPMN from 1988 to 2007 were included. CSS and OS were analyzed using Kaplan-Meier curves. Unadjusted and propensity-score-adjusted Cox proportional-hazards modeling were used for subgroup analyses. RESULTS: 972 patients were included. Adjuvant RT was administered to 31.8% (n=309) of patients. There was no difference in overall median CSS or OS in patients who received adjuvant RT (5-year CSS: 26.5 months; 5-year OS: 23.5 months) versus those who did not (CSS: 28.5 months, P=0.17; OS: 23.5 months, P=0.23). Univariate predictors of survival were lymph node (LN) involvement, T4-classified tumors, and poorly differentiated tumor grade (all P<0.05). In the propensity-score-adjusted analysis, adjuvant RT was associated with improved 5-year CSS [hazard ratio (HR): 0.67, P=0.004] and 5-year OS (HR: 0.73, P=0.014) among all patients with LN involvement, though further analysis by T-classification demonstrated no survival differences among patients with T1/T2 disease; patients with T3/T4-classified tumors had improved CSS (HR: 0.71, P=0.022) but no difference in OS (HR: 0.76, P=0.06). CONCLUSION: On propensity-score-adjusted analysis, adjuvant RT was associated with improved survival in selected subsets of patients with invasive IPMN, particularly those with T3/T4 tumors and LN involvement.

https://www.ncbi.nlm.nih.gov/pubmed/22002799

1534-4681

https://hdl.handle.net/10161/14842

eng

Springer Science and Business Media LLC

Ann Surg Oncol

10.1245/s10434-011-2088-2

Adenocarcinoma, Mucinous

Aged

Carcinoma, Pancreatic Ductal

Cohort Studies

Female

Humans

Lymphatic Metastasis

Male

Middle Aged

Neoplasm Grading

Pancreatic Neoplasms

Radiotherapy, Adjuvant

Registries

Retrospective Studies

Survival Rate

Adjuvant radiotherapy in the treatment of invasive intraductal papillary mucinous neoplasm of the pancreas: an analysis of the surveillance, epidemiology, and end results registry.

Journal article

Chino, JP|0000-0002-3633-9685

https://www.ncbi.nlm.nih.gov/pubmed/22002799

1316

1323

4

Clinical Science Departments

Duke

Duke Cancer Institute

Duke Population Research Institute

Faculty

Institutes and Centers

Institutes and Provost's Academic Units

Physics

Radiation Oncology

Sanford School of Public Policy

School of Medicine

Social Science Research Institute

Trinity College of Arts & Sciences

University Institutes and Centers

Published

19