Has survival improved following resection for pancreatic adenocarcinoma?

Abstract

Introduction: This study was undertaken to determine if survival after resection of pancreatic adenocarcinoma has improved over the past two decades.

Methods: The SEER database was queried for patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1992 to 2010. AJCC Stage and survival were determined for patients. Data were analyzed using Mantel-Cox test and linear regression.

Results: 15,604 patients underwent pancreatectomy from 1992 to 2010. Survival improved from 1992 to 2010 (p < 0.0001); specifically, median survival increased 1992-2010 (p < 0.0001). However, 5-year survival rates did not change 1992-2010. More patients (p = 0.007) underwent resections of Stage I and relatively more patients (p = 0.004) underwent resections of Stage II cancers 2004-2010 with commensurately smaller tumors (p = 0.01).

Conclusions: From 1992 to 2010, progressively more patients underwent pancreatectomy for pancreatic adenocarcinoma with progressively smaller tumors and earlier stages. These patients lived more years (e.g., improved survival curves and median survival) but without improved 5-year survival, denoting better early and intermediate survival. Early detection, better perioperative care, more efficacious noncurative chemotherapy undoubtedly play a role, but better solutions for long-term survival must be sought.

Keywords: Long-term survival; Pancreatic adenocarcinoma; Pancreaticoduodenectomy.