The pathological types of pancreatic carcinoma: an analysis based on US SEER database

Objective To study the component ratios of pancreatic carcinoma, and prognosis of patients with the different pathological types. Methods The data of 92 011 pancreatic carcinoma patients who were diagnosed by the definite pathological method from 2004 to 2014 were extracted from the US SEER database. The life table was used to calculate the 1-, 3- and 5-year survival rates. The Kaplan-Meier was used to construct the survival curves of the patients. The Cox univariate analysis was applied to evaluate the HR of the different pathological types, and the χ2 test and independent sample t-test were used to evaluate the baseline data. Results The overall 5-year survival of 92 011 pancreatic carcinoma patients was 7.6%. The median survival time was 8.8 months and the component ratios of the pancreatic ductal adenocarcinoma (PDAC), pancreatic epithelium cancer bedside the PDAC, neuroendocrine tumors, undifferentiated carcinoma, mesenchymal carcinoma and rare cancer unclassified were 85.78%, 6.40%, 6.67%, 0.97%, 0.10% and 0.08%, respectively. The differences were statistically significant between the baseline data such as age, gender, race and position (P<0.05). The overall 5-year survivals of the PDAC, pancreatic epithelium cancer beside the PDAC, neuroendocrine tumors, undifferentiated carcinoma, mesenchymal carcinoma and rare cancer unclassified were 4.2%, 13.4%, 49.2%, 5.0%, 29.2% and 24.5%, respectively, and the median survival times were 5 months, 7 months, 58 months, 2 months, 26 months and 7 months respectively. The distant metastasis rate of neuroendocrine carcinoma was the lowest (35.0%). The undifferentiated carcinoma was the most prone to distant metastases (65.2%). Basically, half of the other types of pancreatic cancer had metastasis at the time of diagnosis. In pancreatic epithelium cancer beside the PDAC, the high to low 5-year survival rates were solid pseudopapillary carcinoma (87.3%), cystadenocarcinoma (36.8%), intraductal papillary mucinous neoplasm (36.5%), acinar cell carcinoma (20.0%), and pancreatic adenocarcinoma mixed with other subtypes (19.7%). The incidence of the other types of pancreatic carcinoma was less than 8%, such as mucinous carcinoma, squamous cell carcinoma, adenosquamous carcinoma and signet ring cell carcinoma. In neuroendocrine tumor, the 5-year survival rate of insulinoma (77.1%) was higher than those of neuroendocrine tumor (malignant) (NET, 62.0%) and neuroendocrine carcinoma (NEC, 46.5%). Conclusion The prognosis of pancreatic carcinoma was poor, and the pathological types had a significant impact on the prognosis of the patients. Key words: Pancreatic carcinoma; Prognosis; Pathological types; Surveillance, epidemiology, and end results (SEER)