BACKGROUND: Although pancreatic cancer is the fourth leading cause of cancer death, few studies have evaluated population-based trends in diagnosis, management, and outcome. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) registry to evaluate treatment trends and outcomes for patients 18 or older with pancreatic adenocarcinoma diagnosed from 1988 through 2002. RESULTS: We identified 38,073 patients diagnosed with pancreatic cancer over this 15-year period; the age-adjusted incidence did not change over this period. Most patients were diagnosed with metastatic disease (50.3%), few of whom underwent irradiation or cancer-directed surgery (CDS). For patients with localized or regional disease (32.9%), 53% underwent some form of treatment. Importantly, the rate of CDS increased from 19% in 1988 to 35% in 2002 (P < 0.0001). In multivariate analysis, young age, married status, and localized disease were associated with significantly higher CDS rates. For patients with nonmetastatic disease, 2-year survival rate increased from 8% in 1988 to 15% in 2000. For patients with non-metastatic cancer who survived at least 3 months, CDS was associated with a significantly higher 2-year survival rate (CDS, 36%; non-CDS, 10%). CONCLUSIONS: Most patients with pancreatic cancer, even at the end of our 15-year study period, still presented with metastatic disease, and the survival rate for such patients did not change in a meaningful way over time. The proportion of patients with nonmetastatic pancreatic cancer who underwent potentially curative surgery increased over time in the U.S.; the 2-year survival rate for such patients improved, but remained poor.
BACKGROUND: Although pancreatic cancer is the fourth leading cause of cancer death, few studies have evaluated population-based trends in diagnosis, management, and outcome. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) registry to evaluate treatment trends and outcomes for patients 18 or older with pancreatic adenocarcinoma diagnosed from 1988 through 2002. RESULTS: We identified 38,073 patients diagnosed with pancreatic cancer over this 15-year period; the age-adjusted incidence did not change over this period. Most patients were diagnosed with metastatic disease (50.3%), few of whom underwent irradiation or cancer-directed surgery (CDS). For patients with localized or regional disease (32.9%), 53% underwent some form of treatment. Importantly, the rate of CDS increased from 19% in 1988 to 35% in 2002 (P < 0.0001). In multivariate analysis, young age, married status, and localized disease were associated with significantly higher CDS rates. For patients with nonmetastatic disease, 2-year survival rate increased from 8% in 1988 to 15% in 2000. For patients with non-metastatic cancer who survived at least 3 months, CDS was associated with a significantly higher 2-year survival rate (CDS, 36%; non-CDS, 10%). CONCLUSIONS: Most patients with pancreatic cancer, even at the end of our 15-year study period, still presented with metastatic disease, and the survival rate for such patients did not change in a meaningful way over time. The proportion of patients with nonmetastatic pancreatic cancer who underwent potentially curative surgery increased over time in the U.S.; the 2-year survival rate for such patients improved, but remained poor.
Authors: Kien Pham; Daniel Delitto; Andrea E Knowlton; Emily R Hartlage; Ricky Madhavan; David H Gonzalo; Ryan M Thomas; Kevin E Behrns; Thomas J George; Steven J Hughes; Shannon M Wallet; Chen Liu; Jose G Trevino Journal: Am J Pathol Date: 2016-04-18 Impact factor: 4.307
Authors: David C Chang; Yiyi Zhang; Debraj Mukherjee; Christopher L Wolfgang; Richard D Schulick; John L Cameron; Nita Ahuja Journal: J Am Coll Surg Date: 2009-12 Impact factor: 6.113
Authors: Stephen Y Oh; Alicia Edwards; Margaret T Mandelson; Bruce Lin; Russell Dorer; W Scott Helton; Richard A Kozarek; Vincent J Picozzi Journal: World J Gastroenterol Date: 2015-12-28 Impact factor: 5.742
Authors: Russell Lewis; Jeffrey A Drebin; Mark P Callery; Douglas Fraker; Tara S Kent; Jenna Gates; Charles M Vollmer Journal: HPB (Oxford) Date: 2012-09-24 Impact factor: 3.647
Authors: M Javle; J Yu; C Garrett; A Pande; B Kuvshinoff; A Litwin; J Phelan; J Gibbs; R Iyer Journal: Br J Cancer Date: 2009-06-02 Impact factor: 7.640