National Trends in Survival for Pancreatic Adenocarcinoma Based on Location of the Primary Lesion
Gautam K. Malhotra*1, Lynette M. Smith2, Quan P. Ly3, Aaron R. Sasson3, Chandrakanth Are3
1College of Medicine, University of Nebraska Medical Center, Omaha, NE; 2Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE; 3Division of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, Omaha, NE
Background:The management and prognosis of pancreatic adenocarcinoma varies depending on the location of the primary lesion within the pancreas. There is a paucity of data on survival trends in pancreatic adenocarcinoma based on the location. The aim of this study was to analyze the national trends in survival for patients with pancreatic adenocarcinoma based on the location of the primary lesion. Methods:The Surveillance, Epidemiology, and End Results (SEER) database (SEER 17, 1973-2007) was used to identify patients with pancreatic cancer located in the head (C25.0), body (C25.1), or tail (C25.2). SEER*Stat 6.6.2 was used to calculate 5-year survival data. To stabilize rates, we used 5-year cohorts when calculating trends.Results:A total of 89,733 patients were included in the study. The overall 5-year survival, inclusive of all locations and treatment approaches was is 5.4% (95% CI 5.2-5.6%). For lesions in the head, body and tail the overall 5-year survival, inclusive of all treatment approaches, was 5.2% (95% CI 5-5.5%), 3.9% (95% CI 3.4-4.4%) and 7.8% (95% CI 7.2-8.5%) respectively. For patients that underwent surgery, the 5-year survival for patients with lesions in all locations, head, body and tail was 18.8%, 15.9%, 23.8% and 33.8% respectively. When analyzing trends we noted a significant improvement in survival for patients that underwent operative intervention. Comparing the time periods from 1977-1981 versus 2002-2006, the 5-year survival for surgical patients improved for all locations (9.2% to 22.6%, p<0.05) and also for lesions in the head (8.3% to 19.3%, p<0.05), body (6.7% to 26%, p<0.05) and tail (14.7% to 40.7%, p<0.05). Conclusion: The results of our study demonstrate an improvement in survival for patients with pancreatic cancer treated by operative intervention. This improvement in survival was more pronounced for patients with primary lesions located in the body and tail.
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