Detailed Abstract
[BP Oral Presentation 3 - Pancreas Disease/Surgery]
[BP OP 3-1] Is the new T1 category defined by the 8th edition AJCC pancreatic cancer staging system an improvement? An evaluation by multinational data
Wooil KWON1, Jin HE2, Ryota HIGUCHI3, Donghee SON4, Seung Yeoun LEE4, Jaeri KIM1, Sun-Whe KIM1, Christopher WOLFGANG2, John CAMERON2, Masakazu YAMAMOTO3, Jin-Young JANG1
1Department of Surgery, Seoul National University College of Medicine, Korea
2Department of Surgery, Johns Hopkins University School of Medicine, USA
3Department of Surgery, Tokyo Women's Medical University, Japan
4Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Korea, Korea
Introduction : The new T1 pancreatic cancer by the 8th edition AJCC staging system discards the concept of “extension beyond the pancreas” and focuses on size only. Also, the new T1 is divided into T1a, T1b, and T1c based on size. As the T1 pancreatic cancer is very rare, the feasibility of these changes has not been evaluated. The aim was to evaluate the feasibility of the new T1 definition in the pancreas head cancer cohort.
Methods : Data of 540 patients with T1 pancreatic ductal adenocarcinoma defined by the 8th edition were collected from Korea, Japan, and the USA. Invasive IPMNs were excluded. Survival analyses were performed.
Results : Of the 540 patients, 181 patients were T1 by the 7th edition and 359 were down-staged to T1 from the former T3 because the concept of “extension beyond the pancreas” was discarded. The 5-year survival rate and the median survival of T1 patients were 30.6% and 27 months, respectively. Comparing tumors that extend beyond the pancreas (new T1) and those confined within the pancreas (original T1), the latter showed significantly longer median survival (43 vs. 24 months, p<0.001).
Conclusions : The new T1 definition may be more practical, but the implication of the concept of “extension beyond the pancreas” should be re-investigated. Further, the subcategorization of T1a/b/c may not be adequate and may require revision or deletion.
Methods : Data of 540 patients with T1 pancreatic ductal adenocarcinoma defined by the 8th edition were collected from Korea, Japan, and the USA. Invasive IPMNs were excluded. Survival analyses were performed.
Results : Of the 540 patients, 181 patients were T1 by the 7th edition and 359 were down-staged to T1 from the former T3 because the concept of “extension beyond the pancreas” was discarded. The 5-year survival rate and the median survival of T1 patients were 30.6% and 27 months, respectively. Comparing tumors that extend beyond the pancreas (new T1) and those confined within the pancreas (original T1), the latter showed significantly longer median survival (43 vs. 24 months, p<0.001).
Conclusions : The new T1 definition may be more practical, but the implication of the concept of “extension beyond the pancreas” should be re-investigated. Further, the subcategorization of T1a/b/c may not be adequate and may require revision or deletion.
SESSION
BP Oral Presentation 3
Room C 3/30/2018 5:00 PM - 5:50 PM