TY - JOUR
T1 - Nationwide trends in incidence, treatment and survival of pancreatic ductal adenocarcinoma
AU - Dutch Pancreatic Cancer Group
AU - Latenstein, Anouk E J
AU - van der Geest, Lydia G M
AU - Bonsing, Bert A
AU - Groot Koerkamp, Bas
AU - Haj Mohammad, Nadia
AU - de Hingh, Ignace H J T
AU - de Meijer, Vincent E
AU - Molenaar, Izaak Q
AU - van Santvoort, Hjalmar C
AU - van Tienhoven, Geertjan
AU - Verheij, Joanne
AU - Vissers, Pauline A J
AU - de Vos-Geelen, Judith
AU - Busch, Olivier R
AU - van Eijck, Casper H J
AU - van Laarhoven, Hanneke W M
AU - Besselink, Marc G
AU - Wilmink, Johanna W
N1 - Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2020/1
Y1 - 2020/1
N2 - Background: In recent years, new treatment options have become available for pancreatic ductal adenocarcinoma (PDAC) including 5-fluorouracil, leucovorin, irinotecan and oxaliplatin. The impact hereof has not been assessed in nationwide cohort studies. This population-based study aimed to investigate nationwide trends in incidence, treatment and survival of PDAC. Materials and methods: Patients with PDAC (1997–2016) were included from the Netherlands Cancer Registry. Results were categorised by treatment and by period of diagnosis (1997–2000, 2001–2004, 2005–2008, 2009–2012 and 2013–2016). Kaplan–Meier survival analysis was used to calculate overall survival. Results: In a national cohort of 36,453 patients with PDAC, the incidence increased from 12.1 (1997–2000) to 15.3 (2013–2016) per 100,000 (p < 0.001), whereas median overall survival increased from 3.1 to 3.8 months (p < 0.001). Over time, the resection rate doubled (8.3%–16.6%, p-trend<0.001), more patients received adjuvant chemotherapy (3.0%–56.2%, p-trend<0.001) and 3-year overall survival following resection increased (16.9%–25.4%, p < 0.001). Over time, the proportion of patients with metastatic disease who received palliative chemotherapy increased from 5.3% to 16.1% (p-trend<0.001), whereas 1-year survival improved from 13.3% to 21.2% (p < 0.001). The proportion of patients who only received supportive care decreased from 84% to 61% (p-trend<0.001). Conclusion: The incidence of PDAC increased in the past two decades. Resection rates and use of adjuvant or palliative chemotherapy increased with improved survival in these patients. In all patients with PDAC, however, the survival benefit of 3 weeks is negligible because the majority of patients only received supportive care.
AB - Background: In recent years, new treatment options have become available for pancreatic ductal adenocarcinoma (PDAC) including 5-fluorouracil, leucovorin, irinotecan and oxaliplatin. The impact hereof has not been assessed in nationwide cohort studies. This population-based study aimed to investigate nationwide trends in incidence, treatment and survival of PDAC. Materials and methods: Patients with PDAC (1997–2016) were included from the Netherlands Cancer Registry. Results were categorised by treatment and by period of diagnosis (1997–2000, 2001–2004, 2005–2008, 2009–2012 and 2013–2016). Kaplan–Meier survival analysis was used to calculate overall survival. Results: In a national cohort of 36,453 patients with PDAC, the incidence increased from 12.1 (1997–2000) to 15.3 (2013–2016) per 100,000 (p < 0.001), whereas median overall survival increased from 3.1 to 3.8 months (p < 0.001). Over time, the resection rate doubled (8.3%–16.6%, p-trend<0.001), more patients received adjuvant chemotherapy (3.0%–56.2%, p-trend<0.001) and 3-year overall survival following resection increased (16.9%–25.4%, p < 0.001). Over time, the proportion of patients with metastatic disease who received palliative chemotherapy increased from 5.3% to 16.1% (p-trend<0.001), whereas 1-year survival improved from 13.3% to 21.2% (p < 0.001). The proportion of patients who only received supportive care decreased from 84% to 61% (p-trend<0.001). Conclusion: The incidence of PDAC increased in the past two decades. Resection rates and use of adjuvant or palliative chemotherapy increased with improved survival in these patients. In all patients with PDAC, however, the survival benefit of 3 weeks is negligible because the majority of patients only received supportive care.
KW - Epidemiology
KW - Pancreatic cancer
KW - Incidence
KW - Survival
KW - CANCER SURGERY
KW - RESECTION
KW - CENTRALIZATION
KW - CHEMOTHERAPY
KW - PANCREATICODUODENECTOMY
KW - GEMCITABINE
KW - IMPACT
KW - BODY
U2 - 10.1016/j.ejca.2019.11.002
DO - 10.1016/j.ejca.2019.11.002
M3 - Article
C2 - 31841792
SN - 0959-8049
VL - 125
SP - 83
EP - 93
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -