|
2
|
García-Velasco A, Zacarías-Pons L, Teixidor H, Valeros M, Liñan R, Carmona-Garcia MC, Puigdemont M, Carbajal W, Guardeño R, Malats N, Duell E, Marcos-Gragera R. Incidence and Survival Trends of Pancreatic Cancer in Girona: Impact of the Change in Patient Care in the Last 25 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249538. [PMID: 33352812 PMCID: PMC7766657 DOI: 10.3390/ijerph17249538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/24/2022]
Abstract
(1) Background: We investigated the incidence and survival trends for pancreatic cancer (PC) over the last 25 years in the Girona region, Catalonia, Spain; (2) Methods: Data were extracted from the population-based Girona Cancer Registry. Incident PC cases during 1994–2015 were classified using the International Classification of Diseases for Oncology Third Edition (ICD-O-3). Incidence rates age-adjusted to the European standard population (ASRE) and world standard population (ASRW) were obtained. Trends were assessed using the estimated annual percentage of change (EAPC) of the ASRE13. Observed and relative survivals (RS) were estimated with the Kaplan–Meier and Pohar Perme methods, respectively; (3) Results: We identified 1602 PC incident cases. According to histology, 44.4% of cases were exocrine PC, 4.1% neuroendocrine, and 51.1% malignant-non-specified. The crude incidence rate (CR) for PC was 11.43 cases-per-100,000 inhabitants/year. A significant increase of incidence with age and over the study period was observed. PC overall 5-year RS was 7.05% (95% confidence interval (CI) 5.63; 8.84). Longer overall survival was observed in patients with neuroendocrine tumours (5-year RS 61.45%; 95% CI 47.47; 79.55). Trends in 5-year RS for the whole cohort rose from 3.27% (95% CI 1.69–6.35) in 1994–1998 to 13.1% (95% CI 9.98; 17.2) in 2010–2015; (4) Conclusions: Incidence rates of PC in Girona have increased in the last two decades. There is a moderate but encouraging increase in survival thorough the study period. These results can be used as baseline for future research.
Collapse
Affiliation(s)
- Adelaida García-Velasco
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
- Correspondence:
| | - Lluís Zacarías-Pons
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Helena Teixidor
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Marc Valeros
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Raquel Liñan
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
| | - M. Carmen Carmona-Garcia
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
| | - Montse Puigdemont
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Walter Carbajal
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
| | - Raquel Guardeño
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research (CNIO) and CIBERONC, 28029 Madrid, Spain;
| | - Eric Duell
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 08908 Barcelona, Spain;
| | - Rafael Marcos-Gragera
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), 28029 Madrid, Spain
| |
Collapse
|
|
3
|
Khalil A, Ewald J, Marchese U, Autret A, Garnier J, Niccoli P, Piana G, Poizat F, Giovannini M, Delpero JR, Turrini O. A single-center experience with pancreatic cystic neuroendocrine tumors. World J Surg Oncol 2020; 18:208. [PMID: 32799893 PMCID: PMC7429455 DOI: 10.1186/s12957-020-01994-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/06/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Pancreatic neuroendocrine tumors (PNET) are rare, with a significant malignant potential. This study aimed to determine outcomes of patients with resected PNETs according to the cystic component and confirm the accuracy of preoperative staging. METHODS From 1997 to 2016, 106 patients underwent resection of PNETs, including 73 purely solid (S-PNETs, 69%), 21 mixed (M-PNETs, 20%), and 12 purely cystic lesions (C-PNETs, 11%). To ensure consistent comparisons of overall (OS) and disease-free (DFS) survival outcomes between the 3 groups, the patients were matched according to the World Health Organization (WHO) grade and tumor height. RESULTS Overall, the rate of correlation between the preoperative and pathological diagnoses was low in the C-PNET group (33%, P = 0.03). None of the 24 patients (23%) with metastatic disease at the time of surgery were in the C-PNET group. Furthermore, significantly more parenchyma-sparing resections (P = 0.039) and fewer enlarged resections (P = 0.019) were achieved in the C-PNET group. C-PNET group had a significantly lower node invasion rate than the S-PNET and M-PNET groups (8% vs. 41% and 24%, P = 0.004). Although median OS was comparable in all 3 groups before (P = 0.3) and after (P = 0.18) matching, higher median DFS was observed in the C-PNET group than in the other groups after matching (P = 0.038). CONCLUSION C-PNET was associated with a better prognosis than PNET with a solid component. The results support a wait-and-see policy in cases wherein a reliable preoperative diagnosis remains challenging.
Collapse
Affiliation(s)
- Ange Khalil
- Department of Surgery, ENETS co-E IPC NET Center, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France.
| | - Jacques Ewald
- Department of Surgery, ENETS co-E IPC NET Center, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Ugo Marchese
- Department of Surgery, ENETS co-E IPC NET Center, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Aurélie Autret
- Department of Biostatistics, Institut Paoli-Calmettes, Marseille, France
| | - Jonathan Garnier
- Department of Surgery, ENETS co-E IPC NET Center, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Patricia Niccoli
- Department of Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Gilles Piana
- Department of Radiology, Institut Paoli-Calmettes, Marseille, France
| | - Flora Poizat
- Department of Pathology, Institut Paoli-Calmettes, Marseille, France
| | - Marc Giovannini
- Department of Endoscopy, Institut Paoli-Calmettes, Marseille, France
| | - Jean-Robert Delpero
- Department of Surgery, ENETS co-E IPC NET Center, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Olivier Turrini
- Department of Surgery, CNRS, Inserm, CRCM, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France
| |
Collapse
|