Short- and Long-Term Survival in Metastatic Pancreatic Adenocarcinoma, 1993–2013

Abstract

During the past 2 decades, numerous clinical trials have focused on improving outcomes in patients with metastatic pancreatic cancer (mPDAC). The efficacy of new treatments has been demonstrated among highly selected patients in randomized phase III trials; hence, it is not clear to what extent these advances are reflected within the broader mPDAC population. Survival statistics were extracted from the SEER database for patients diagnosed with mPDAC between 1993 and 2013. Survival was analyzed using the Kaplan-Meier method and proportional hazard models. The study population consisted of 57,263 patients diagnosed with mPDAC between 1993 and 2013; 52% were male, with a median age of 69 years (range, 15-104). Superior prognosis correlated with younger age, being married, tumor located within the head of the pancreas, lower grade disease, and more recent year of diagnosis. Median overall survival (OS) remained stable at 2 months between 1993 and 2013. Improvements in OS were seen for younger patients (age <50 years) and those with a more recent year of diagnosis (2009-2013). The percentage of patients who died within 2 months of initial diagnosis decreased between 1993 and 2013 (from 63.5% to 50.6%; <.0001). The percentage of patients surviving ≥12 months improved from 4.9% in 1993 to 12.7% in 2013 (<.0001). In recent years a modest improvement in OS has been seen among younger patients with mPDAC. The percentage of patients living beyond 1 year has significantly increased over time; however, the percentage of those dying within 2 months remains substantial.

Clinico‐pathological features and survival of patients with malignant exocrine pancreatic neoplasms: The AC Camargo Cancer Center experience

“…This is slightly superior to the survival found in the pivotal MPACT trial, that assessed the activity of the combination of Gemcitabine plus Nab‐Paclitaxel in the first‐line setting . It also exceeds by far the overall survival of patients assessed through national cancer databases, highlighting the potential benefit of centralized pancreatic cancer also in the metastatic setting . Therefore, we believe the incorporation of new chemotherapeutic regimens and treatment techniques has favorably impacted the outcomes of patients with advanced pancreatic cancer in recent years.…”

Identification of potential crucial genes associated with the pathogenesis and prognosis of pancreatic adenocarcinoma

“…Data between 1974 and 2013 has demonstrated that the overall increase in the incidence of PAAD is associated with risk factors such as smoking, obesity and diabetes in the USA (2). In recent decades the proportion of patients with metastatic PAAD with survival time >1 year has increased significantly, but the proportion of deaths within 2 months is still considerable (50.6%; P<0.001) (3). The median overall survival (OS) is ~16 months after resection in patients with non-metastatic pancreatic ductal adenocarcinoma, but the resectability rate is also low, <10% (4).…”

Retrospective review of outcomes in patients with DNA-damage repair related pancreatic cancer

“…Median all stage overall pancreatic cancer survival has been reported as 14 months for those with a pathogenic BRCA1/2 variant [6]. For reference, those with metastatic pancreatic cancer generally have an estimated median survival below 6 months [7,8]. Following clear margin removal of a pancreatic tumor, median survival time increases to around 23 months [8,9].…”