The role of risk factors on survival for patients with pancreatic cancer

Background

Previous epidemiological studies have shown that diabetes mellitus (DM), alcohol, smoking and pancreatic cancer (PC) in close relatives are risk factors for developing PC. We investigated if these known risk factors are associated with short overall survival (OS) in patients with PC.

Methods

629 patients with pancreatic ductal adenocarcinoma (PDAC) (M/F 346/283, stage I (n = 22), stage II (n = 183), stage III (90) and stage IV (n = 334)) and 53 patients with ampullary adenocarcinoma (AAC) (M/F 32/20, stage I (n = 11), stage II (n = 26), stage III (13) and stage IV (n = 3)) were included from 6 hospitals in the Danish BIOPAC project from July 2008 to April 2016. Baseline clinical characteristics, IDDM, NIDDM, patient's history of cancer or family history of cancer were retrospectively registered and analyzed. Hazard ratios (HR) were estimated for OS by means of Cox proportional hazards model.

Results

117 (19%) of the PDAC and 5 (11%) of the AAC patients had known IDDM or NIDDM at time of diagnosis. 471 (69%) had family history of cancer; most common types were breast cancer (7%), colorectal cancer (6.7%), lung cancer (6.7%), PC (6%) and uterus (3.4%). 36.7% were former smokers and 30% were current smokers. 25% had previous or present high alcohol intake. Known IDDM and NIDDM at time of diagnosis were associated with short OS (HR = 1.52, 95% CI 1.11-2.07, p = 0.01 and HR = 1.36, 95% CI 1.00-1.83, p = 0.05, respectively). Present or previous high alcohol intake, tobacco use, family history of cancer or own earlier cancer or gastrointestinal inflammation were not associated with poor prognosis.

Conclusions

In this Danish multicenter study we demonstrated that known IDDM and NIDDM at time of diagnosis were the only risk factors associated with poor prognosis.

Clinical trial identification

BIOPAC, version 3, 16 february 2016

Approved by the National Committee on Health Research Ethics
(VEK nr. KA-20060113)

The Danish Data Protection Agency
(j.nr.2012-58-0004; HGH-2015-027; I-Suite nr: 03960)

Legal entity responsible for the study

The National Committee on Health Research Ethics The Danish Data Protection Agency

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.