Modest Improvement in Overall Survival for Patients With Metastatic Pancreatic Cancer

Worni, Mathias; Güller, Ulrich; White, Rebekah R.; Castleberry, Anthony W.; Pietrobon, Ricardo; Cerny, Thomas; Gloor, Beat; Köberle, Dieter (2013). Modest Improvement in Overall Survival for Patients With Metastatic Pancreatic Cancer. Pancreas, 42(7), pp. 1157-1163. Lippincott Williams & Wilkins 10.1097/MPA.0b013e318291fbc5

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OBJECTIVES: Patients with pancreatic adenocarcinoma often present with distant metastatic disease. We aimed to assess whether improvements in survival of clinical trials translated to a population-based level. METHODS: The US Surveillance, Epidemiology, and End Results registry was queried. Adult patients with distant metastatic adenocarcinoma of the pancreas were included from 1988 to 2008. Overall survival was analyzed using Kaplan-Meier curves as well as multivariable-adjusted Cox proportional hazards models. RESULTS: In total, 32,452 patients were included. Mean age was 67.6 (SD: 11.7) years, and 15,341 (47.3%) were female. Median overall survival was 3 months (95% confidence interval [CI], 3-3 months), which increased from 2 (CI, 2-2) months in 1988 to 3 (CI, 3-4) months in 2008. After adjustment for multiple covariates, the hazard ratio (HR) decreased by 0.977 per year (CI, 0.975-0.980). In multivariable-adjusted survival analyses, tumor location in the pancreatic body/tail (HR, 1.10), male sex (HR, 1.09), increasing age (HR, 1.016), African American ethnicity (HR, 1.16), nonmarried civil status (HR, 1.18), and absence of radiotherapy (HR, 1.41) were associated with worse survival (P < 0.001 for all predictors). CONCLUSIONS: The improvement in overall survival over the past 2 decades among patients with metastatic pancreatic adenocarcinoma is modest and disappointing. More effective therapeutic strategies for advanced disease are desperately needed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Worni, Mathias; Güller, Ulrich and Gloor, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0885-3177

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

16 Jun 2014 13:50

Last Modified:

06 Nov 2015 09:59

Publisher DOI:

10.1097/MPA.0b013e318291fbc5

Uncontrolled Keywords:

adenocarcinoma, metastasis, pancreatic cancer, SEER, survival

BORIS DOI:

10.7892/boris.53183

URI:

https://boris.unibe.ch/id/eprint/53183

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