Original Scientific Articles
Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database1

https://doi.org/10.1016/S1072-7515(99)00075-7Get rights and content

Abstract

Background: The National Cancer Database is an electronic registry system sponsored jointly by the American College of Surgeons Commission on Cancer and the American Cancer Society. Patients diagnosed with pancreatic adenocarcinoma from 1985 to 1995 were analyzed for trends in stage of disease, treatment patterns, and outcomes.

Study Design: Seven annual requests for data were issued by the National Cancer Database from 1989 through 1995. Data on 100,313 patients were voluntarily submitted using a standardized reporting format.

Results: The anatomic site distribution was: head, 78%; body, 11%; and tail, 11%. The ratios of limited to advanced disease (Stage I/Stage IV) were 0.70 for tumors in the head, 0.24 for body tumors, and 0.10 for tail tumors. Of all patients, 83% did not have a surgical procedure and 58% did not have cancer-directed treatment. Resection was done for 9,044 (9%) patients, including 22% of those with Stage I disease. The overall 5-year survival rate was 23.4% for patients who had pancreatectomy, compared with 5.2% for those who had no cancer-directed treatment.

Conclusions: Overall survival rates for pancreatic cancer have not changed in 2 decades. A small minority of patients presented with limited, resectable disease, but the best survival rates per stage were achieved after surgical resection. Five-year survival rates after resection reported herein corroborated the improved survival rates of more recent large, single institution studies.

Section snippets

Methods

Seven annual requests for data on pancreatic cancer were issued by the NCDB from 1989 through 1995 to approximately 1,340 hospitals with programs approved by the Commission on Cancer, as well as to 760 other hospitals, central and state registries, and software suppliers. Data on 103,720 patients with pancreatic cancer diagnosed from 1985–1995 were voluntarily submitted using standardized definitions, instructions, and data report formats.

The methodology of the NCDB has been described elsewhere.

Age, anatomic site, grade, and location of treatment

The distribution of pancreatic adenocarcinoma for 100,313 patients by AJCC combined stage according to age and anatomic site is shown in Table 1. Also presented in this table is the ratio of the number of patients with resectable disease confined to the pancreas (Stage I) to the number of those with metastatic disease (Stage IV). The peak age of occurrence was 70 to 79 years. Only 6% of all patients were less than 50 years of age, and 18% were over 80 years at the time of presentation. The

Discussion

The data collected for this study represent a convenient sample of voluntarily submitted patient information. So, possible limitations in the representativeness of the data must be kept in mind. A recent analysis of the NCDB8 concluded that it is most representative of cancer patients who receive definitive diagnosis or treatment at a US hospital. It is less likely to be representative of patients who had disease diagnosed or treated outside of a hospital environment.

Despite the availability of

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1

No competing interests declared.

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