title: Long-term survival in patients with pancreatic ductal adenocarcinoma.
abstract: Long-term survival (LTS) is uncommon for patients with pancreatic ductal adenocarcinoma (PDAC). We sought to identify factors that predict 10-year, LTS after resection of PDAC.
  
  
  
  We identified all patients with PDAC who underwent resection at UCLA after 1990 and included all patients eligible for observed LTS (1/1/1990-12/31/2004). An independent pathologist reconfirmed the diagnosis of PDAC in patients with LTS. Logistic regression was used to predict LTS on the basis of patient and tumor characteristics.
  
  
  
  Of 173 included patients, 53% were male, median age at diagnosis was 66 years, and median survival was 23 months. The rate of observed LTS was 12.1% (n = 21). Age, sex, number of lymph nodes evaluated, margin status, lymphovascular invasion, and adjuvant chemotherapy and radiation were not associated with LTS. The following were associated with LTS on bivariate analysis: low AJCC stage (Ia, Ib, IIa) (P = .034), negative lymph node status (P = .034), low grade (well-, moderately-differentiated) (P = .001), and absence of perineural invasion (P = .019). Only low grade (odds ratio 7.17, P = .012) and absent perineural invasion (odds ratio 3.28, P = .036) were independently associated with increased odds of LTS. Our multivariate model demonstrated good discriminatory power for LTS, as indicated by a c-statistic of 0.7856.
  
  
  
  Absence of perineural invasion and low tumor grade were associated with greater likelihood of LTS. Understanding the tumor biology of LTS may provide critical insight into a disease that is typically marked by aggressive behavior and limited survival.
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
authors: Alexander P
authors: AP
authors: Stark
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Department of Surgery, Greater Los Angeles VA Healthcare System, Los Angeles, CA.
authors: Greg D
authors: GD
authors: Sacks
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Department of Surgery, Greater Los Angeles VA Healthcare System, Los Angeles, CA.
authors: Matthew M
authors: MM
authors: Rochefort
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
authors: Timothy R
authors: TR
authors: Donahue
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
authors: Howard A
authors: HA
authors: Reber
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Department of Surgery, Greater Los Angeles VA Healthcare System, Los Angeles, CA.
authors: James S
authors: JS
authors: Tomlinson
authors: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
authors: David W
authors: DW
authors: Dawson
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
authors: Guido
authors: G
authors: Eibl
authors: Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA. Electronic address: joehines@mednet.ucla.edu.
authors: O Joe
authors: OJ
authors: Hines
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate