Abstract
Background
Familial pancreatic cancer (FPC) is defined as a family in which at least two first-degree relatives have pancreatic cancer (PC). The prognostic significance of PC in an FPC family after surgery is not fully understood.
Methods
This was a retrospective study of 427 patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma between January 2008 and December 2016. PC patients who also had at least one first-degree relative with PC were defined as FPC patients. The associations between recurrence and clinicopathological characteristics were analyzed for both FPC and non-FPC patients.
Results
FPC patients accounted for 31 of the 427 (7.3%) patients. Recurrence occurred in 72.1% of the total cohort and in 87.1% of the 31 FPC patients. Multivariate analysis showed that being an FPC patient was an independent predictor for relapse-free survival (RFS) (hazard ratio [HR] 1.52, P = 0.038). Although univariate analysis revealed that being an FPC patient was significantly associated with poorer overall survival (OS) (P < 0.001), multivariate analysis showed that being an FPC patient was not an independent predictor for OS (P = 0.164). Dichotomization of the 427 patients into those who received (n = 317: 17 FPC and 300 non-FPC patients) and did not receive (n = 110: 14 FPC and 96 non-FPC patients) adjuvant chemotherapy revealed that being an FPC patient was an independent predictor for RFS (HR 2.50, P < 0.001) and OS (HR 2.30, P = 0.003) only for patients who received adjuvant chemotherapy.
Conclusions
This study has shown that being an FPC patient is a significant prognostic indicator for PC patients who undergo resection and receive adjuvant chemotherapy.
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Abbreviations
- PC:
-
Pancreatic cancer
- FPC:
-
Familial pancreatic cancer
- PDAC:
-
Pancreatic ductal adenocarcinoma
- US:
-
Ultrasonography
- CT:
-
Computed tomography
- RPC:
-
Resectable pancreatic cancer
- PV/SMV:
-
Portal vein and/or superior mesenteric vein
- BRPC:
-
Borderline resectable pancreatic cancer
- UICC:
-
Union for International Cancer Control
- RFS:
-
Relapse-free survival
- OS:
-
Overall survival
- HR:
-
Hazard ratio
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The authors would like to thank all the medical staff who were involved in this study.
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KT and YO contributed to the study conception and design, and development of the methodology. All authors participated in acquisition, analysis and interpretation of the data. KT and YO were responsible for the first draft of the manuscript. All authors contributed to the review, and/or critical revision of the manuscript, and read and approved the final version.
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Tezuka, K., Okamura, Y., Sugiura, T. et al. The influence of familial pancreatic cancer on postoperative outcome in pancreatic cancer: relevance to adjuvant chemotherapy. J Gastroenterol 56, 101–113 (2021). https://doi.org/10.1007/s00535-020-01730-7
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DOI: https://doi.org/10.1007/s00535-020-01730-7