title: Early onset pancreatic malignancies: Clinical characteristics and survival associations.
abstract: Diagnosed before age 50, early onset pancreatic malignancy (EOPM), is hypothesized to be a distinct subset of disease, although research is limited. To better characterize EOPM, and the effect of age at diagnosis on pancreatic cancer survival, we examined clinical characteristics and survival in EOPM and typical age-at-onset pancreatic malignancy (TOPM) cases. Vanderbilt University Medical Center (VUMC) Cancer Registry confirmed pancreatic adenocarcinomas (PDACs) and malignant pancreatic neuroendocrine tumors (PNETs) were evaluated. Clinical characteristics were compared using χ(2) tests. Overall survival was visualized with Kaplan-Meier functions; Cox proportional hazards regression was used to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 1,697 pancreatic malignancies were diagnosed at the VUMC between 1988 and 2013. Of 1,407 PDACs, 118 (8.4%) were EOPM, which was associated with significantly better survival (adjusted HR: 0.82, 95% CI: 0.67-1.00). EOPM and TOPM PDACs significantly differed with regard to having multiple malignancies; survival associations significantly differed by race, stage of disease, treatment and multiple malignancies. Of 190 PNETs, 63 (33.1%) were EOPM, which was not significantly associated with survival (adjusted HR: 0.80, 95% CI: 0.46-1.40). Malignant neuroendocrine EOPM and TOPM cases significantly differed by stage of disease and tumor location; survival associations significantly differed by family history of pancreatic cancer, stage of disease and multiple malignancies. Differences in clinical characteristics and associations with survival were identified, indicating that EOPM is distinct from TOPM, and exists among both pancreatic adenocarcinomas and malignant pancreatic neuroendocrine tumors.
authors.affiliation: Division of Epidemiology, School of Medicine, Vanderbilt University Medical Center and Vanderbilt Ingram Comprehensive Cancer Center, Nashville, TN.
authors.forename: Alicia
authors.initials: A
authors.lastname: Beeghly-Fadiel
authors.affiliation: Division of Epidemiology, School of Medicine, Vanderbilt University Medical Center and Vanderbilt Ingram Comprehensive Cancer Center, Nashville, TN.|Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Hung N
authors.initials: HN
authors.lastname: Luu
authors.affiliation: School of Medicine, Center for Quantitative Sciences, Vanderbilt University Medical Center and Vanderbilt Ingram Comprehensive Cancer Center, Nashville, TN.
authors.forename: Liping
authors.initials: L
authors.lastname: Du
authors.affiliation: Department of Pathology, School of Medicine, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Chanjuan
authors.initials: C
authors.lastname: Shi
authors.affiliation: Vanderbilt Cancer Registry, Vanderbilt University Medical Center and Vanderbilt Ingram Comprehensive Cancer Center, Nashville, TN.
authors.forename: Dauphne P
authors.initials: DP
authors.lastname: McGavic
authors.affiliation: Division of Surgical Oncology and Endocrine Surgery, School of Medicine, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Parikh
authors.affiliation: Division of Epidemiology, School of Medicine, Vanderbilt University Medical Center and Vanderbilt Ingram Comprehensive Cancer Center, Nashville, TN. leonid.raskin@vanderbilt.edu.
authors.forename: Leon
authors.initials: L
authors.lastname: Raskin
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D014481:United States / Q000453:epidemiology
keywords: PDAC; PNET; early onset; pancreatic cancer; survival