Prognostic Analysis of Different Metastatic Patterns in Invasive Intraductal Papillary Mucinous Neoplasm: A Surveillance, Epidemiology, and End Results Database Analysis

Objective. To evaluate the impacts of different metastatic patterns on the prognosis of patients with invasive intraductal papillary mucinous neoplasm (IPMN). Materials and Methods. All patients who were diagnosed with invasive IPMN in the Surveillance, Epidemiology, and End Results SEER database (2010–2015) were included in this study. They were grouped according to different metastatic patterns. Kaplan–Meier analysis and log-rank test were used for the comparison of their survival rates. The hazard ratio (HR) with 95% confidence interval (CI) was analyzed using the Cox proportional-hazards model. Results. A total of 2264 cases were included in this study. The most common metastatic site was the liver. The patients with the nonorgan metastasis demonstrated the best survival outcomes, while those with multiple metastases showed the worst survival outcomes. As compared to the patients with isolated liver metastasis, those with isolated lung and other organ metastases showed better overall survival rates and tumor-specific survival rates. The patients with liver, lung, multiple, and other organ metastases or of age >60 years were the independent predictors of poor prognosis. Conclusions. The patients with isolated lung and other organ metastases demonstrated better survival outcomes as compared to those with isolated liver metastasis. The patients with nonorgan metastasis demonstrated the best survival outcomes, while those with multiple metastases showed the worst survival outcomes. Further studies are needed to determine a highly selected subset of patients, who might benefit from surgery or chemotherapy.

Download Full-text

Sites of Distant Metastases and Cancer-Specific Survival in Intraductal Papillary Mucinous Neoplasm With Associated Invasive Carcinoma: A Study of 1,178 Patients

Frontiers in Oncology ◽

10.3389/fonc.2021.681961 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xiaoyi Huang ◽

Siting You ◽

Guiling Ding ◽

Xingchen Liu ◽

Jin Wang ◽

...

Keyword(s):

Risk Factor ◽

Invasive Carcinoma ◽

Cox Regression ◽

Distant Metastases ◽

Cancer Specific Survival ◽

Mucinous Neoplasm ◽

Isolated Lung ◽

Multiple Metastases ◽

The Impact ◽

Isolated Liver

BackgroundTo explore the impact of distant metastases on cancer-specific survival in patients with intraductal papillary mucinous neoplasm (IPMN) with associated invasive carcinoma and identify the risk factor of distant metastases in IPMN with associated invasive carcinoma.MethodsPatients with IPMN with associated invasive carcinoma between 2010 and 2015 were retrospectively selected from the Surveillance, Epidemiology, and End Results (SEER) database. The survival analyses were assessed by Kaplan-Meier analyses and log-rank test. The impact of distant metastases was evaluated by Cox regression model and the risk factors of distant metastases were identified by logistic regression analyses, respectively.ResultsThe median cancer-specific survival time of patients with no metastases, isolated liver, isolated lung, and multiple site metastases were 19 months, 4 months, 7 months, and 3 months, respectively. In patients with isolated liver metastases, multivariate analysis after adjustment indicated that chemotherapy (Hazard Ratio [HR]=0.351, 95% confidence interval [CI]=0.256-0.481, P<0.001) was a protective prognostic factor for cancer-specific survival (CSS) in patients with isolated liver metastases. In isolated lung metastases subgroup, old age (HR=1.715, 95% CI=1.037-2.838, P=0.036) and chemotherapy (HR=0.242, 95% CI=0.134-0.435, P<0.001) were related to CSS in multivariable Cox regression analysis(P<0.05). Tumor located in the pancreatic body/tail (HR=2.239, 95% CI=1.140-4.400, P=0.019) and chemotherapy (HR=0.191, 95% CI=0.108-0.340, P<0.001) were independent prognostic factors for CSS in patients with multiple metastases. Finally, a nomogram was constructed for cancer-specific survival and the predicted C-index was 0.780 (95% CI=0.762-0.798).ConclusionThe liver is the most common site of distant metastases in IPMN with associated invasive carcinoma. Tumor located in the pancreatic body/tail and chemotherapy are independent prognostic factors for CSS in patients with multiple metastases. Further, tumor located in body/tail is identified as a risk factor of distant metastases.

Download Full-text

Invasive intraductal papillary mucinous neoplasm of the pancreas with multiple metastases: A case report and review

Journal of Medical Case Reports and Case Series ◽

10.38207/jmcrcs/2021/0219254 ◽

2021 ◽

Keyword(s):

Case Report ◽

Intraductal Papillary Mucinous Neoplasm ◽

Mucinous Neoplasm ◽

Multiple Metastases

Download Full-text

Adjuvant Radiotherapy in the Treatment of Invasive Intraductal Papillary Mucinous Neoplasm of the Pancreas: an Analysis of the Surveillance, Epidemiology, and End Results Registry

Annals of Surgical Oncology ◽

10.1245/s10434-011-2088-2 ◽

2011 ◽

Vol 19 (4) ◽

pp. 1316-1323 ◽

Cited By ~ 19

Author(s):

Mathias Worni ◽

Igor Akushevich ◽

Beat Gloor ◽

John Scarborough ◽

Junzo P. Chino ◽

...

Keyword(s):

Intraductal Papillary Mucinous Neoplasm ◽

Adjuvant Radiotherapy ◽

Mucinous Neoplasm ◽

End Results

Download Full-text

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

10.21203/rs.3.rs-76624/v2 ◽

2021 ◽

Author(s):

Yingnan Yang ◽

Zhuolong Tu ◽

Chentao Ye ◽

Huajie Cai ◽

Shouzhang Yang ◽

...

Keyword(s):

Bone Metastases ◽

Prognostic Value ◽

Primary Site ◽

Survival Outcomes ◽

Seer Database ◽

Site Specific ◽

Isolated Lung ◽

Gallbladder Adenocarcinoma ◽

Metastatic Sites ◽

Isolated Liver

Abstract Background: Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan-Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival.Results: Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P>0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P<0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases.Conclusions: The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.

Download Full-text

The Cancers-Specific Survival of Metastatic Pulmonary Carcinoids and Sites of Distant Metastasis: A Population-Based Study

Technology in Cancer Research & Treatment ◽

10.1177/15330338211036528 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110365

Author(s):

Jiandong Zhang ◽

Qiongjie Yu ◽

Yi He ◽

Tingting Hu ◽

Kun Chen ◽

...

Keyword(s):

Liver Metastasis ◽

Distant Metastasis ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Related Factors ◽

Cancer Specific Survival ◽

Pulmonary Carcinoid ◽

Pulmonary Carcinoids ◽

Isolated Liver

Background: Lung cancer is the leading cause of cancer-related deaths and pulmonary carcinoids (PCs) account for almost 2% of all pulmonary malignancies. However, few published articles have reported prognosis and related factors of pulmonary carcinoid patients. Material and Method: The Surveillance, Epidemiology, and End Results (SEER) database was used to collect data of patients diagnosed with metastatic PCs from 2010 to 2016. The prognosis and survival of these patients were compared by employing Cox proportional hazards and the Kaplan-Meier survival analysis. Results: A total of 1763 patients were analyzed. The liver (668, 25.6%) was shown to be the most common metastatic site in the isolated organ metastasis cohort, followed by the lung (636, 24.4%), bone (562, 21.6%), and brain (460, 17.6%). Among the patients, the tumor metastasized to a single distant site included the liver, bone, lung, and brain. Cancer-specific survival (CSS) in metastatic PCs is determined by the site of metastasis and the total number of such sites. Pulmonary carcinoid patients with isolated liver metastasis manifested more favorable survival rates in comparison to patients having isolated metastasis in the lung, brain, or bone. The median CSS was 45, 7, 6, 5 months ( P = 0.011). The number of distant metastatic sites and the location of distant metastasis were found to be independent risk factors for CSS. For patients with distant isolated metastasis, liver metastasis ( P < 0.0001) had better CSS in comparison to those with bone metastasis. When compared to patients whose carcinoids had metastasized to the bones, patients with a brain ( P = 0.273) or lung ( P = 0.483) metastasis had the same CSS. Conclusion: Cancer-specific survival in metastatic PCs depends on the site of metastasis and the total number of such locations. PC patients with isolated liver metastasis manifested more favorable survival in comparison to patients with isolated metastasis in the lung, brain, or bone.

Download Full-text

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

BMC Surgery ◽

10.1186/s12893-021-01068-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yingnan Yang ◽

Zhuolong Tu ◽

Chentao Ye ◽

Huajie Cai ◽

Shouzhang Yang ◽

...

Keyword(s):

Bone Metastases ◽

Prognostic Value ◽

Primary Site ◽

Survival Outcomes ◽

Seer Database ◽

Site Specific ◽

Isolated Lung ◽

Gallbladder Adenocarcinoma ◽

Metastatic Sites ◽

Isolated Liver

Abstract Background Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan–Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival. Results Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P > 0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P < 0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases. Conclusions The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.

Download Full-text

Site-specific Metastases of Gallbladder Adenocarcinoma and Their Prognostic value for Survival: A SEER-based Study

10.21203/rs.3.rs-76624/v1 ◽

2020 ◽

Author(s):

Yingnan Yang ◽

Zhuolong Tu ◽

Chentao Ye ◽

Huajie Cai ◽

Shouzhang Yang ◽

...

Keyword(s):

Bone Metastases ◽

Prognostic Value ◽

Primary Site ◽

Survival Outcomes ◽

Seer Database ◽

Site Specific ◽

Isolated Lung ◽

Gallbladder Adenocarcinoma ◽

Metastatic Sites ◽

Isolated Liver

Download Full-text

Evaluating malignant intraductal papillary mucinous neoplasm: A population-based study.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.324 ◽

2013 ◽

Vol 31 (4_suppl) ◽

pp. 324-324

Author(s):

Carrie Luu ◽

Rebecca A. Nelson ◽

Byrne Lee ◽

Gagandeep Singh ◽

Joseph Kim

Keyword(s):

Multivariate Analysis ◽

Lymph Nodes ◽

Intraductal Papillary Mucinous Neoplasm ◽

Univariate Analysis ◽

Survival Rates ◽

Tumor Grade ◽

Population Based ◽

Curative Surgery ◽

Mucinous Neoplasm ◽

Invasive Ipmn

324 Background: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas has been increasingly recognized. Due to a paucity of evidence, the management and treatment of IPMN is still under debate. We hypothesize that with increased awareness, the incidence and resection rates for IPMN would increase. Using a population-based cancer registry, we examined incidence, prognostic factors, and survival for IPMN. Methods: Patients diagnosed with invasive IPMN from 1988 to 2009 were identified by the Surveillance, Epidemiology, and End Results (SEER) database. Patient demographics, clinical and pathologic factors, and therapies received (surgery and/or radiation) were analyzed. Survival was assessed by Kaplan-Meier method; Cox proportional hazard modeling was used for multivariate analysis. Results: 2,987 patients were identified. Over the study period, there was a decrease in age-adjusted incidence. The overall resection rate was 20.6% with an increase in annual rates of resection. On univariate analysis, age greater than 65 years, tumor location, poorly differentiated tumor grade, higher T stage, and positive lymph nodes predicted worse survival; more recent diagnosis, higher number of lymph nodes examined, and surgery were indicators of improved survival. On multivariate analysis, curative surgery remained predictive of survival. Patients who underwent surgery had median survival rates of 87, 18, and 14 months compared to 6, 7, and 5 months in the no surgery group for stages I, II, and III, respectively. Conclusions: Although recent reports show increasing incidence of IPMN, our study involving a population-based cohort demonstrates decreasing incidence of malignant IPMN. This may be accounted for by increased detection of non-malignant disease. It is imperative that we identify patients with invasive IPMN early so that they may benefit from the survival advantage conferred by curative resection.

Download Full-text