title: Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value.
abstract: OBJECTIVE
  Even with the development of new biopsy methods, diagnosis of pancreatic cancer is sometimes without histological evidence. The aim of our study is to find out the status of pancreatic cancer patients who are diagnosed without pathologic confirm and the prognostic value of pathologic diagnosis.
  
  
  METHODS
  We identified 52,759 pancreatic adenocarcinoma patients from the Surveillance, Epidemiology, and End RESULTS (SEER) database. Logistic regression model was used to identify factors relating to no pathologic diagnosis. Multivariable Cox regression model identified potential prognostic factors. All statistical tests were two-sided.
  
  
  RESULTS
  There were 6206 (11.76%) patients without pathologic diagnosis. Older age, reported from nursing/convalescent home/hospice or physician's office/private medical practitioner, early year of diagnosis, larger tumor size, pancreatic head cancer, unmarried patients, uninsured and stage I disease all contributed to no pathologic diagnosis. Median cause specific-survival for patients with and without pathologic diagnosis were 7.72 and 3.52 months, respectively. The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001.
  
  
  CONCLUSIONS
  Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients. New diagnostic methods are needed to get the pathologic diagnosis.
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.; 2. Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.
authors.forename: Miaozhen
authors.initials: M
authors.lastname: Qiu
authors.affiliation: 3. Department of VIP, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Qiu
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jin
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Wei
authors.affiliation: 3. Department of VIP, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Zixian
authors.initials: Z
authors.lastname: Wang
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Deshen
authors.initials: D
authors.lastname: Wang
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ren
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Huiyan
authors.initials: H
authors.lastname: Luo
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Zhang
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Fenghua
authors.initials: F
authors.lastname: Wang
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Li
authors.affiliation: 4. Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, China.
authors.forename: Dajun
authors.initials: D
authors.lastname: Yang
authors.affiliation: 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Ruihua
authors.initials: R
authors.lastname: Xu
keywords: Pancreatic adenocarcinoma; Pathologic diagnosis; Prognosis; SEER.