Article Figures & Data
Figures
- Figure 1.
Overall survival curves of patients with pancreatic cancer by prediagnostic leukocyte telomere length [quintile 1 (shortest) vs. quintile 5 (longest)]. Survival probabilities were adjusted for age at diagnosis (continuous), cohort (HPFS, NHS, PHS, or WHI; also adjusted for sex), race/ethnicity (white, black, other, or unknown), year of diagnosis (continuous), smoking status (never, past, current, or unknown), BMI (<25, 25–29.9, 30–34.9, or ≥35 kg/m2), diabetes status (yes or no), and cancer stage (localized, locally advanced, metastatic, or unknown). Q1, quintile 1; Q5, quintile 5.
- Figure 2.
Forest plot and meta-analysis of HRs for overall mortality per SD decrease in prediagnostic leukocyte telomere length among patients with pancreatic cancer in the HPFS, NHS, PHS, and WHI. Squares and horizontal lines indicate cohort-specific multivariable-adjusted HRs and 95% CIs, respectively. Area of the square reflects cohort-specific weight (inverse of the variance). Diamond indicates pooled multivariable-adjusted HR (center) and 95% CI (width). HRs were adjusted for age at diagnosis (continuous), cohort (HPFS, NHS, PHS, or WHI; also adjusted for sex), race/ethnicity (white, black, other, or unknown), year of diagnosis (continuous), smoking status (never, past, current, or unknown), BMI (<25, 25–29.9, 30–34.9, or ≥35 kg/m2), diabetes status (yes or no), and cancer stage (localized, locally advanced, metastatic, or unknown).
Tables
- Table 1.
Baseline characteristics of patients with pancreatic cancer
Characteristica Pancreatic cancer cases (n = 423) Age at blood collection, years 64.7 ± 8.8 Age at cancer diagnosis, years 71.9 ± 7.8 Female sex 283 (66.9) Race/ethnicity White 369 (87.2) Black 16 (3.8) Other 10 (2.4) Unknown 28 (6.6) Year of diagnosis 1984–2000 219 (51.8) 2001–2008 204 (48.2) Median time from blood collection to cancer diagnosis, years 6.1 Smoking status Never 183 (43.2) Past 179 (42.3) Current 57 (13.5) Unknown 4 (1.0) BMI, kg/m2 26.5 ± 5.1 Physical activity, MET-hours/week 17.9 ± 22.9 History of diabetes 28 (6.6) Cancer stage at diagnosis Localized 53 (12.5) Locally advanced 103 (24.4) Metastatic 194 (45.8) Unknown 73 (17.3) Median survival time by stage, months Localized 16 Locally advanced 10 Metastatic 4 Abbreviation: MET, metabolic equivalent of task.
↵aData are presented as mean ± SD or number of patients (%), unless otherwise noted.
- Table 2.
Overall survival among patients with pancreatic cancer by quintiles of prediagnostic leukocyte telomere length
Leukocyte telomere length Q5 (longest) Q4 Q3 Q2 Q1 (shortest) Ptrendc Person-months 1,266 777 886 721 858 Number of cases/deaths 84/79 85/78 85/80 85/82 84/82 Median survival, months 8 6 7 5 5 Age-adjusted HR (95% CI) 1 (referent) 1.27 (0.93–1.74) 1.29 (0.94–1.76) 1.42 (1.04–1.94) 1.29 (0.94–1.76) 0.06 Multivariable HRa (95% CI) 1 (referent) 1.20 (0.87–1.66) 1.08 (0.79–1.49) 1.36 (0.98–1.88) 1.39 (1.01–1.93) 0.04 Multivariable HRb (95% CI) 1 (referent) 1.18 (0.85–1.63) 1.07 (0.78–1.48) 1.37 (0.99–1.91) 1.38 (0.99–1.91) 0.04 Abbreviation: Q1–5, quintiles 1–5.
↵aThe Cox proportional hazards regression model was adjusted for age at diagnosis (continuous), cohort (HPFS, NHS, PHS, or WHI; also adjusted for sex), race/ethnicity (white, black, other, or unknown), year of diagnosis (continuous), smoking status (never, past, current, or unknown), BMI (<25, 25–29.9, 30–34.9, or ≥35 kg/m2), diabetes status (yes or no), and cancer stage (localized, locally advanced, metastatic, or unknown).
↵bFurther adjusted for time from blood collection to cancer diagnosis (<5, 5–10, or ≥10 years).
↵cPtrend was calculated by entering quintile-specific median values of leukocyte telomere length (continuous) in the Cox regression model.
- Table 3.
Overall survival among patients with pancreatic cancer by quartiles of prediagnostic leukocyte telomere length, stratified by time from blood collection to cancer diagnosis
Multivariable HR (95% CI) for quartiles of leukocyte telomere lengthb Time from blood collection to cancer diagnosisa Number of cases Q4 (longest) Q3 Q2 Q1 (shortest) Ptrendc 0 to <6.1 years 212 1 (referent) 1.05 (0.69–1.59) 0.79 (0.52–1.21) 1.10 (0.71–1.69) 0.96 ≥6.1 years 211 1 (referent) 1.11 (0.74–1.68) 1.42 (0.93–2.17) 1.60 (1.02–2.50) 0.03 Abbreviation: Q1–4, quartiles 1–4.
↵aDichotomized by the median value.
↵bThe Cox proportional hazards regression model was adjusted for age at diagnosis (continuous), cohort (HPFS, NHS, PHS, or WHI; also adjusted for sex), race/ethnicity (white, black, other, or unknown), year of diagnosis (continuous), smoking status (never, past, current, or unknown), BMI (<25, 25–29.9, 30–34.9, or ≥35 kg/m2), diabetes status (yes or no), and cancer stage (localized, locally advanced, metastatic, or unknown).
↵cPtrend was calculated by entering quartile-specific median values of leukocyte telomere length (continuous) in the Cox regression model.
- Table 4.
Overall survival among patients with pancreatic cancer by quartiles of prediagnostic leukocyte telomere length, stratified by covariates
Multivariable HR (95% CI) for quartiles of leukocyte telomere lengtha Stratification variable Number of cases Q4 (longest) Q3 Q2 Q1 (shortest) Pinteractionb Sex 0.87 Female 283 1 (referent) 1.15 (0.81–1.63) 1.29 (0.92–1.82) 1.30 (0.88–1.92) Male 140 1 (referent) 1.00 (0.56–1.77) 1.07 (0.59–1.94) 1.23 (0.73–2.06) Smoking status 0.64 Never 183 1 (referent) 1.00 (0.62–1.63) 0.93 (0.60–1.45) 0.98 (0.61–1.60) Past 179 1 (referent) 0.87 (0.56–1.36) 1.73 (1.09–2.77) 1.46 (0.92–2.31) Current 57 1 (referent) 3.07 (0.98–9.62) 0.81 (0.27–2.45) 1.01 (0.32–3.16) BMI 0.99 <30 kg/m2 341 1 (referent) 1.04 (0.75–1.43) 1.20 (0.86–1.67) 1.23 (0.89–1.71) ≥30 kg/m2 82 1 (referent) 0.90 (0.41–1.99) 1.16 (0.55–2.43) 1.32 (0.58–3.01) Cancer stage 0.26 Localized 53 1 (referent) 1.48 (0.43–5.14) 1.44 (0.55–3.74) 1.67 (0.67–4.14) Locally advanced 103 1 (referent) 0.88 (0.49–1.60) 1.04 (0.54–2.03) 1.41 (0.70–2.81) Metastatic 194 1 (referent) 0.99 (0.65–1.52) 0.94 (0.61–1.47) 1.07 (0.67–1.71) Abbreviation: Q1–4, quartiles 1–4.
↵aThe Cox proportional hazards regression model was adjusted for the following covariates except for the stratification variable: age at diagnosis (continuous), cohort (HPFS, NHS, PHS, or WHI; also adjusted for sex), race/ethnicity (white, black, other, or unknown), year of diagnosis (continuous), smoking status (never, past, current, or unknown), BMI (<25, 25–29.9, 30–34.9, or ≥35 kg/m2), diabetes status (yes or no), and cancer stage (localized, locally advanced, metastatic, or unknown).
↵bPinteraction was calculated by entering a cross-product term of quartile-specific median values of leukocyte telomere length (continuous) and stratification variable in the Cox regression model and evaluating likelihood ratio tests.
Supplementary Data
- Supplementary Tables 1-5 - Supplementary Table S1. Baseline characteristics of patients with pancreatic cancer by cohort. Supplementary Table S2. Distribution of cancer stage among pancreatic cancer patients by quintiles of prediagnostic leukocyte telomere length. Supplementary Table S3. Overall survival among patients with pancreatic cancer by quintiles of prediagnostic leukocyte telomere length, excluding patients diagnosed within two years of blood collection. Supplementary Table S4. Association of SNPs at the TERT gene locus with overall survival among patients with pancreatic cancer, ranked by association P value. Supplementary Table S5. Overall survival among patients with pancreatic cancer by quartiles of prediagnostic leukocyte telomere length, stratified by SNPs at the TERT gene locus that have been associated with leukocyte telomere length.
Volume 28, Issue 11
