J Cancer 2016; 7(6):694-701. doi:10.7150/jca.14185

Research Paper

Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value

Miaozhen Qiu1,2*, Huijuan Qiu3*, Ying Jin1, Xiaoli Wei1, Yixin Zhou3, Zixian Wang1, Deshen Wang1, Chao Ren1, Huiyan Luo1, Feng Wang1, Dongsheng Zhang1, Fenghua Wang1, Yuhong Li1, Dajun Yang4✉, Ruihua Xu1✉

1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
2. Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.
3. Department of VIP, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
4. Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, China.
*Miaozhen Qiu and Huijuan Qiu contributed equally to this paper.

Abstract

Purpose: Even with the development of new biopsy methods, diagnosis of pancreatic cancer is sometimes without histological evidence. The aim of our study is to find out the status of pancreatic cancer patients who are diagnosed without pathologic confirm and the prognostic value of pathologic diagnosis.

Methods: We identified 52,759 pancreatic adenocarcinoma patients from the Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression model was used to identify factors relating to no pathologic diagnosis. Multivariable Cox regression model identified potential prognostic factors. All statistical tests were two-sided.

Results: There were 6206 (11.76%) patients without pathologic diagnosis. Older age, reported from nursing/convalescent home/hospice or physician's office/private medical practitioner, early year of diagnosis, larger tumor size, pancreatic head cancer, unmarried patients, uninsured and stage I disease all contributed to no pathologic diagnosis. Median cause specific-survival for patients with and without pathologic diagnosis were 7.72 and 3.52 months, respectively. The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001.

Conclusions: Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients. New diagnostic methods are needed to get the pathologic diagnosis.

Keywords: Pancreatic adenocarcinoma, Pathologic diagnosis, Prognosis, SEER.

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How to cite this article:
Qiu M, Qiu H, Jin Y, Wei X, Zhou Y, Wang Z, Wang D, Ren C, Luo H, Wang F, Zhang D, Wang F, Li Y, Yang D, Xu R. Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value. J Cancer 2016; 7(6):694-701. doi:10.7150/jca.14185. Available from http://www.jcancer.org/v07p0694.htm