Impact of Tumor Location on Survival Outcomes in Pancreatic Head Versus Body/Tail Cancer: Institutional Experience.

Simple Summary: Pancreatic cancer is a serious disease with different outcomes depending on whether the tumor is in the head or the body/tail of the pancreas. This study explores why these differences exist and how they affect patients' survival when treated with standard chemotherapy. By analyzing...

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Publicado en:Cancers Vol. 17; no. 11; pp. 1777 - 1791
Autores principales: Esmail, Abdullah, Dhillon, Vikram, Al-Najjar, Ebtesam, Khasawneh, Bayan, Alghamdi, Mohammed, Ibnshamsah, Fahad, Abdelrahim, Maen
Formato: research tables/charts Journal Article
Publicado: MDPI Jun2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2025
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      pub: MDPI
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        10.3390/cancers17111777
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        atl: Impact of Tumor Location on Survival Outcomes in Pancreatic Head Versus Body/Tail Cancer: Institutional Experience.
      aug:
        au:
          Esmail, Abdullah
          Dhillon, Vikram
          Al-Najjar, Ebtesam
          Khasawneh, Bayan
          Alghamdi, Mohammed
          Ibnshamsah, Fahad
          Abdelrahim, Maen
        affil: Section of GI Oncology, Department of Medicine, Houston Methodist Neal Cancer Center, Houston, TX 77030, USA
      sug:
        subj:
          Pancreatic Neoplasms Drug Therapy
          Antineoplastic Agents, Combined Therapeutic Use
          Chemotherapy, Cancer
          Treatment Outcomes
          Pancreatic Neoplasms Prognosis
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Texas
          Retrospective Design
          Record Review
          Electronic Health Records
          Prospective Studies
          Cancer Patients
          Survival Analysis
          Gemcitabine Therapeutic Use
          Paclitaxel Therapeutic Use
          Neoplasm Staging
          Overall Survival
          Progression-Free Survival
          Kaplan-Meier Estimator
          Cox Proportional Hazards Model
          Structural Equation Modeling
          Latent Structure Analysis
          Comparative Studies
          Descriptive Statistics
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Simple Summary: Pancreatic cancer is a serious disease with different outcomes depending on whether the tumor is in the head or the body/tail of the pancreas. This study explores why these differences exist and how they affect patients' survival when treated with standard chemotherapy. By analyzing data from over 600 patients, the researchers aim to understand which treatments work best for each tumor location and identify patient groups with unique characteristics that could guide personalized care. This work may also encourage other researchers to explore tailored approaches for this challenging disease, advancing care strategies for better patient outcomes. Background: Pancreatic ductal adenocarcinoma (PDAC) exhibits variable survival outcomes based on tumor location, with pancreatic head cancer (PHC) and pancreatic body/tail cancer (PBTC) differing in prognosis and treatment response. This study investigates the correlation between tumor location and survival outcomes in PDAC patients treated with standard chemotherapy regimens. Methods: A retrospective analysis of 604 PDAC patients (400 PHC, 204 PBTC) diagnosed between January 2015 and May 2024 at Houston Methodist Neal Cancer Center was conducted. Patients received either mFOLFIRINOX or gemcitabine/nab-paclitaxel as first-line therapy. Clinical data, including demographics, tumor stage, treatment modalities, and molecular profiles, were extracted from electronic records. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan–Meier analyses and Cox proportional hazards models. Latent class analysis (LCA) identified patient subgroups based on shared clinical, demographic, and survival characteristics. Results: PHC patients demonstrated superior median OS (12 months) compared to PBTC (9 months, p = 0.012) and PFS (8 months vs. 5 months, p = 0.0008). Across both subtypes, mFOLFIRINOX was associated with significantly longer OS than gem/nab-paclitaxel (PHC: 18.8 vs. 12.7 months, p < 0.0001; PBTC: 14 vs. 6 months, p = 0.011). LCA revealed distinct clusters: in PHC, a curative-intent class (median OS > 24 months) contrasted with a palliative class (<6 months); in PBTC, an aggressive treatment class (median OS > 18 months) differed from a limited treatment class (<6 months). Cluster differences were linked to treatment intensity, stage, and radiation use. Conclusions: PHC is associated with better survival outcomes than PBTC, with mFOLFIRINOX outperforming gem/nab-paclitaxel in both subtypes. LCA highlights heterogeneous patient subgroups, suggesting opportunities for personalized treatment strategies in PDAC management.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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