Survival improvement in patients with pancreatic cancer by decade: a period analysis of the SEER database, 1981-2010

Abstract

Pancreatic cancer (PaCa) is an aggressive malignancy with a high mortality rate and a poor prognosis. To evaluate treatment outcomes of patients with pancreatic cancer over the past three decades, data from the Surveillance, Epidemiology, and End Results (SEER) registries were used to assess the survival of patients with PaCa. A total of 63,530 patients diagnosed with pancreatic cancer between 1981 and 2010 were identified from nine original SEER registries. The 1-year relative survival rates (RSRs) improved each decade, from 17.0% to 19.9% to 28.2% (p < 0.0001), with a larger increase during the third decade than during the second decade. However, the long-term survival rates have remained very low. The 5-year RSRs increased from 3.1% to 4.4% to 6.9% over these three decades--i.e., still only few patients with PaCa survive more than 5 years. Furthermore, our analysis demonstrated that the survival rates for all the patients with pancreatic cancer were lower in patients of lower socioeconomic status and black race. These results will help predict future trends in PaCa incidence and survival, contribute to better-designed clinical trials by eliminating disparities that may affect the results, and thereby improve the clinical management and outcomes of PaCa.

Figure 1. Summary incidences of patients diagnosed with PaCa between 1981 and 2010 at the original nine SEER sites.

Incidence (a) and number (b) of PaCa cases are shown by age group (total and ages 0–49, 50–64, 65–79, and 80+ years) and calendar period. Incidence (c, d, e) of PaCa cases are grouped by sex, SES, and race, respectively.

Figure 2. Trends in 10-year relative survival rates (a) and Kaplan-Meier survival analysis (b) for patients with PaCa at nine SEER sites between 1981 and 2010 according to age group (total and ages 0–49, 50–64, 65–79, and 80+ years) and calendar period.

Figure 3. Six-month relative survival rates from 1981 to 2010 (a) and Kaplan-Meier survival analysis from 2001 to 2010 (b) for patients with PaCa at nine SEER sites according to sex by age group (total and ages 0–49, 50–64, 65–79, and 80+ years).

Figure 4. Six-month, 12-month, and 18-month relative survival rates according to race (a) and SES/county-level poverty rates (b) and Kaplan-Meier survival analysis according to race (c) and SES/county-level poverty rates (d) for patients with PaCa at nine SEER sites from 1981 to 2010.