Epidemiological and clinicopathological features of patients (pts) with early- (EOPC) and late-onset pancreatic cancer (LOPC): A mono-institutional retrospective analysis.
Authors: Bensi Maria , Salvatore Lisa , Lenkowicz Jacopo , Bagalà Cinzia , Chiaravalli Marta , Iacomini Chiara , Barone Diletta , Gurreri Enrico , Di Giorgi Nicoletta , Spring Alexia , Beccia Viria , Di Bello Armando , Trovato Giovanni , Quero Giuseppe , Alfieri Sergio , Valentini Vincenzo , Tortora Giampaolo 
Published: June 2023

10533

Background: PC is mostly diagnosed in the 7th decade of life. Recent evidence suggests a rising incidence of both EOPC and LOPC. However, there are few data about their specific characteristics. The aim of our study is to determine the incidence of EOPC and LOPC and their correlation with epidemiological and clinicopathological features. Methods: Real world data were extracted and analyzed by the Gemelli GENERATOR within the Gemelli Science and Technology Park (G-STeP). Study population was identified from health records matching main inclusion criteria: hospitalized pts with a diagnosis of PC (International Classification of Disease 9, ICD-9 codes captured from structured data source) or pts with at least one anatomic pathology report including PC evidence (selected using clinically validated text mining techniques from unstructured data source). Two subgroups were defined: EOPC ( < 50 years old) and LOPC ( > 75 years old) pts. Epidemiological and clinicopathological variables (gender; age, BMI, diabetes, history of pancreatitis, histology, primary tumor site, primary tumor surgery) were extracted using SAS (SAS(R) Institute suite for ETL). Statistical analyses were conducted using R (v4.2.1). Results: From January 2018 to December 2020, a total of 1606 PC pts treated at our Institution were included in the analysis. The median age was 69 years, 51% were male and the median BMI was 25. Regarding comorbidities, only 4% and 3% of pts had diabetes and history of pancreatitis, respectively. Adenocarcinoma (1120/1126; 99%) was the most common histotype and pancreatic head (576/901, 64%) was the most frequent primary tumor site. Two hundred and ninety-three pts (18%) underwent primary tumor surgery. Concerning the two subgroups, 92 (6%) pts had EOPC and 510 (32%) had LOPC. The median age was 43 years in EOPC group and 81 years in LOPC group. No difference between the two groups was found in gender (p 0.83), BMI (p 1) and tumor histology (p 1). Diabetes was present in 1% and 7% of EOPC and LOPC pts (p 0.07) and pancreatitis history in 3% and 2% (p 0.79), respectively. The primary tumor site was pancreatic head in 78% and 65% (p 0.06) of LOPC and EOPC, respectively. Regarding primary tumor surgery, a significant difference was observed between the two groups (27% in EOPC pts vs 11% LOPC pts; p < 0.001). Conclusions: In our study, we did not observe a different epidemiology or a distinctive clinicopathological profile between EOPC and LOPC pts. Despite the retrospective nature of our analysis and single-institution evaluation, our findings showed that EOPC pts more frequently underwent primary tumor surgery, probably related to better clinical conditions. Additional analyses on survival outcomes, molecular and genetic features may help to clarify differences between the two groups.