@article{16a0931d8a6342aab368379daffda9de,
title = "Features of T1 pancreatic cancer and validation of the eighth edition AJCC staging system definition using a Korean–Japanese joint cohort and the SEER database",
abstract = "Background/Purpose: Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition. Method: Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed. The results were validated using 3092 T1 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database. Results: The median survival duration of patients was 50 months, and the 5-year survival rate was 45.1%. R0 resection was unachievable in 10.0% of patients, the nodal metastasis rate was 40.0%, and recurrence occurred in 55.2%. The current T1 subcategorization was not feasible for PDAC, tumors with extrapancreatic extension (72.8%) had worse outcomes than those without extrapancreatic extension (median survival 107 vs. 39 months, p <.001). Extrapancreatic extension was an independent prognostic factor whereas the current T1 subcategorization was not. The results of this study were reproducible with data from the SEER database. Conclusion: Despite its small size, T1 PDAC displayed aggressive behavior warranting active local and systemic treatment. The subcategorization by the eighth edition of the AJCC staging system was not adequate for PDAC, and better subcategorization methods need to be explored. In addition, the role of extrapancreatic extension in the staging system should be reconsidered.",
keywords = "T1, extrapancreatic extension, pancreatic cancer, stage, subcategorization",
author = "Wooil Kwon and Heo, {Jin Seok} and Han, {In Woong} and Kang, {Chang Moo} and Hwang, {Ho Kyoung} and Kim, {Song Cheol} and Park, {Sang Jae} and Yoon, {Yoo Seok} and Kim, {Yong Hoon} and Lim, {Chang Sup} and Lee, {Seung Yeoun} and Taesung Park and Hideki Takami and Nobuyuki Watanabe and Yasuhiro Shimizu and Masataka Okuno and Hiroki Yamaue and Manabu Kawai and Hirono Seiko and Yuichi Nagakawa and Hiroaki Osakabe and Teiichi Sugiura and Hirochika Toyama and Masayuki Ohtsuka and Michiaki Unno and Itaru Endo and Minoru Kitago and Jang, {Jin Young}",
note = "Funding Information: We would like to acknowledge Joon Seong Park (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea), Huisong Lee (Department of Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea), Jae Do Yang (Department of Surgery, Jeonbuk National University Hospital, Jeonju, Korea), Young-dong Yu (Department of Surgery, Korea University Anam Hospital, Seoul, Korea), In Seok Choi (Department of Surgery, College of Medicine, Konyang University, Daegu, Korea), Seong-Ryong Kim (Department of Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea), Seung Eun Lee (Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea), Chi-Young Jeong (Department of Surgery, Gyeongsang National University College of Medicine, Jinju, Korea), Jaewoon Choi (Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea), Younghoon Roh (Department of Surgery, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea), Sang Kuon Lee (Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea), Takehiro Okabayashi (Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan), Toru Hisaka (Department of Surgery, Kurume University School of Medicine, Kurume, Japan), Atsuyuki Maeda (Department of Surgery, Ogaki Municipal Hospital, Gifu, Japan), Yuji Soejima (Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan), Hiroaki Nagano (Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan), Hiromi Ohtani (Department of Gastroenterological Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan), Masafumi Nakamura (Department of Surgery and Oncology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan), Munenori Tahara (Department of Surgery, Sapporo Kosei General Hospital, Sapporo, Japan), Koji Amaya (Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan), Sohei Satoi (Department of Surgery, Kansai Medical University, Hirakata, Japan), Shugo Mizuno (Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, Mie, Japan), Junichiro Yamauchi (Gastrointestinal Surgery, Sendai Kousei Hospital, Sendai, Japan), Hiroshi Uchinami (Department Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan), Masayuki Sho (Department of Surgery, Nara Medical University, Nara, Japan), Shigehiro Shiozaki (Department of Surgery, Hiroshima City Hiroshima Citizens Hospital), Teijiro Hirashita (Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan), and Ken Shirabe (Division of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan) for their contributions to data acquisition. Funding Information: This research was supported by a grant of the Collaborative Genome Program for Fostering New Post‐Genome Industry of the National Research Foundation funded by the Ministry of Science and ICT (NRF‐2017M3C9A5031591). Publisher Copyright: {\textcopyright} 2023 Japanese Society of Hepato-Biliary-Pancreatic Surgery.",
year = "2023",
month = sep,
doi = "10.1002/jhbp.1316",
language = "English",
volume = "30",
pages = "1129--1140",
journal = "Journal of Hepato-Biliary-Pancreatic Sciences",
issn = "1868-6974",
publisher = "Springer Verlag",
number = "9",
}
