Sangjeong Ahn
Pusan National University Hospital, South Korea
Title: Can we use alternative tumor size criteria in T3 sub-classification of pancreas head cancer?
Biography
Biography: Sangjeong Ahn
Abstract
Background: Pathologic tumor staging is the most powerful predictor. However tumor staging of pancreatic cancer has been known to be less predictive because most surgically resected pancreatic cancer corresponds to T3. We hypothesized current T3 included wide range of cases and suspected tumor size can be useful parameter to induce alternative pathologic T3 sub-staging system. Method: We reviewed surgically resected 151 pancreatic head cancer cases during 2006~2009. The receiver operating characteristic curve was used to verity that tumor size is a superior predictor of survival to pT stage. Further a recursive partitioning technique with the log-rank test was used to identify a significant cutoff value for the sub-staging of tumor size of pancreas head cancer using. Result: Among total 151 cases, 2 cases were staged as T2 (1.3%), 148 cases as T3 (96.1%) and 4 cases as T4 (2.6%), respectively. The mean size of tumor was 3.0 cm, ranging 1.4~6.0 cm. ROC curve analysis revealed that tumor size reflects patients survival better than current pT stage of AJCC 7th edition (AUC=0.707, P=0.001; AUC=0.530, P=0.626). The cutoff value of tumor size was 2.4 cm and 3.6 cm, which segregated patients into 3 groups: Each group with statistically significant decreasing length of median survival (P<0.001). Conclusion: We found tumor size cutoff value 2.4 cm and 3.6 cm could be an alternative size criteria in sub-classification of pathologic T3 pancreatic head carcinoma. Here we propose an alternative size criterion in T sub-classification of pancreas head cancer.
