Non-surgical tissue biopsy among patients with advanced pancreatic cancer: effect on survival.
OBJECTIVE
The aim was to determine the survival of patients with advanced, unresectable pancreatic cancer in relation to whether they underwent nonsurgical biopsy of their primary tumor.


METHODS
A total of 1481 patients with distant stage pancreatic cancer diagnosed between 1992 and 2001 who underwent radiation treatment but not cancer-directed surgery were analyzed. The design is a retrospective cohort study from the Surveillance, Epidemiology, and End Results program of the US National Cancer Institute. Survival curves were created using Kaplan-Meier method and compared via log-rank test.


RESULTS
Of 1481 patients (median age, 66 years) included in our analysis, 1406 (95%) underwent nonsurgical biopsy (95%) and 75 (5%) did not. There was no statistically significant difference in overall median survival according to receipt of nonsurgical biopsy (Kaplan-Meier curve, log-rank test = 0.09). A subgroup analysis of patients younger than 65 years who did not undergo biopsy revealed a hazard ratio of 1.76 (95% confidence interval, 1.14-2.72); that is, there was a 76% higher hazard for death among younger patients who did not undergo biopsy compared with those who did (P = 0.011).


CONCLUSIONS
Nonsurgical biopsy did not seem to negatively impact survival among patients with advanced pancreatic cancer.
Hernandez
Lyndon V
LV
Harvard School of Public Health, Boston, MA, USA. lhernan@mcw.edu
Bhutani
Manoop S
MS
Eisner
Milton
M
Guda
Nalini M
NM
Lu
Na
N
Geenen
Joseph E
JE
Catalano
Marc F
MF
D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data*; D015331:Cohort Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000532:radiotherapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D012720:Severity of Illness Index