Are risk factors associated with outcomes in pancreatic cancer?
BACKGROUND
The development of pancreatic cancer is a process in which genes interact with environmental factors. We performed this study to determine the effects of the ABO blood group, obesity, diabetes mellitus, metabolic syndrome (MetS), smoking, alcohol consumption and hepatitis B viral (HBV) infection on patient survival.


METHODS
A total of 488 patients with pancreatic cancer were evaluated.


RESULTS
Patients who presented as chronic carriers of HBV infection were younger at disease onset (p = 0.001) and more predominantly male (p = 0.020) than those never exposed to HBV. Patients with MetS had later disease staging (p = 0.000) and a lower degree of pathological differentiation (p = 0.008) than those without MetS. In a univariate analysis, the ABO blood group, smoking and alcohol consumption were not associated with overall survival. HBsAg-positivity and elevated fasting plasma glucose were significantly associated with unfavorable survival though not in the multivariate analysis. The presence of MetS (HR: 1.541, 95% CI: 1.095-2.169, p = 0.013), age ≥65, an elevated CA19-9 baseline level, TNM staging, the type of surgery, the degree of differentiation and chemotherapy were independently associated with overall survival.


CONCLUSIONS
We report, for the first time, that patients with chronic HBV infection may represent a special subtype of pancreatic cancer, who have a younger age of disease onset and male dominancy. Patients with MetS had later disease staging and a poorer histological grade. Patients with MetS demonstrated significantly poorer survival.
State Key Laboratory of Oncology in South China, Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
De-shen
DS
Wang
Zhi-qiang
ZQ
Wang
Le
L
Zhang
Miao-zhen
MZ
Qiu
Hui-yan
HY
Luo
Chao
C
Ren
Dong-sheng
DS
Zhang
Feng-hua
FH
Wang
Yu-hong
YH
Li
Rui-hua
RH
Xu
D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome