Pancreatic cancer: A report of treatment and survival trends for 100,313 patients diagnosed from 1985-1995, using the National Cancer Database

Background: The National Cancer Database is an electronic registry system s ponsored jointly by the American College of Surgeons Commission on Cancer a nd the American Cancer Society. Patients diagnosed with pancreatic adenocar cinoma from 1985 to 1995 were analyzed for trends in stage of disease, trea tment patterns, and outcomes. Study Design: Seven annual requests for data were issued by the National Ca ncer Database from 1989 through 1995. Data on 100,313 patients were volunta rily 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, in eluding 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 thos e 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, resectab le disease, but the best survival rates per stage were achieved after surgi cal resection. Five-year survival rates after resection reported herein cor roborated the improved survival rates of more recent large, single institut ion studies. (J Am Cell Surg 1999;189:1-7. (C) 1993 by the American College of Surgeons).