Clinicopathologic and survival differences in younger patients with pancreatic ductal adenocarcinoma-A propensity score-matched comparative analysis

Background/objectives: Early-onset pancreatic cancer (EOPC) is not optimally characterized because of its extremely low incidence. We investigated clinicopathologic differences between younger or older patients with pancreatic cancer, and compared their outcomes.

Methods: We enrolled 699 consecutive patients who were diagnosed with pancreatic ductal adenocarcinoma and admitted to our surgical department between 2000 and 2014. We compared demographics and clinical outcomes in patients who were younger and older than 45 years at diagnosis. We estimated 1:2 case propensity score matching (PSM) by a logistic regression model based on patients' ASA scores, postoperative AJCC stages, adjuvant chemotherapy and radiotherapy.

Results: At diagnosis 34 patients (4.9%) were younger than 45 years. After PSM, tested variables and median survival periods were not significantly different between two groups. Some 441 patients (63.1%) suffered postoperative recurrence, but did not significantly differ by age for local (14.7 vs. 18.5%, P = 0.658) or systemic recurrence (70.6 vs. 54.4%, P = 0.077). There was a significant difference of disease-free survival (DFS) after PSM (8.9 vs. 29.3%, P = 0.011).

Conclusions: Five-year OS and recurrence patterns did not significantly differ between two groups. But five-year DFS was significantly worse after PSM and systemic recurrence tended to be more frequent in the younger group.