TY - JOUR
T1 - 10-year survival after resection of pancreatic ductal adenocarcinoma with pathological re-examination of a nationwide cohort
AU - Verkolf, E. M.M.
AU - Dekker, E. N.
AU - van der Geest, L. G.
AU - Besselink, M. G.
AU - Bonsing, B. A.
AU - Bruno, M. J.
AU - Sarasqueta, A. Farina
AU - de Hingh, I. H.J.T.
AU - Homs, M. Y.V.
AU - Jamieson, N. B.
AU - de Meijer, V. E.
AU - van Velthuysen, M. F.
AU - Verheij, J.
AU - de Vos-Geelen, J.
AU - de Wilde, R. F.
AU - Doukas, M.
AU - Koerkamp, B. Groot
N1 - Publisher Copyright:
© 2025 The Authors.
PY - 2025/12/9
Y1 - 2025/12/9
N2 - Background: Resection of pancreatic ductal adenocarcinoma (PDAC) is performed with curative intent, yet, long-term overall survival (OS) remains rare. This nationwide study assessed 10-year OS after resection of PDAC with diagnostic confirmation through pathological re-examination. Methods: Patients were identified from the Netherlands Cancer Registry (NCR; 2000–2020). Kaplan-Meier survival analysis was performed to estimate the 10-year OS of the entire cohort, and for each of four consecutive 5-year periods to assess survival changes over time. Pathology data of patients who survived beyond 10 years was re-examined by two or more pancreatic pathologists. Results: Among 5553 resected PDAC patients (2000–2020), estimated 10-year OS was 10.6 % with significant improvement across 5-year periods (P < 0.001). Actual 10-year OS after resection was reached by 179 patients (7.3 %). Review of available pathology reports (n = 173) revealed another diagnosis than PDAC (misregistration) in 21 patients (12.1 %). Of the remaining 152 patients, tissue could be retrieved for 108 patients (71.1 %), of whom 21 (19.4 %) had a different diagnosis after pathological re-examination (misclassification). Alternative diagnoses were benign (i.e., pancreatitis), premalignant (i.e., non-invasive IPMN), or other malignancies (i.e., distal cholangiocarcinoma, ampullary, duodenal, or acinar cell carcinoma). Of the 87 patients with confirmed PDAC, 12 patients (13.8 %) had a histological subtype other than conventional (classic) PDAC (e.g., adenosquamous or colloid carcinoma). After excluding the 42 misregistered or misclassified patients (24.3 %), the true observed 10-year OS after resection of PDAC was 5.3 %. Conclusion: The observed 10-year OS after resection of PDAC in a nationwide cohort was only 5.3 % after pathological re-examination.
AB - Background: Resection of pancreatic ductal adenocarcinoma (PDAC) is performed with curative intent, yet, long-term overall survival (OS) remains rare. This nationwide study assessed 10-year OS after resection of PDAC with diagnostic confirmation through pathological re-examination. Methods: Patients were identified from the Netherlands Cancer Registry (NCR; 2000–2020). Kaplan-Meier survival analysis was performed to estimate the 10-year OS of the entire cohort, and for each of four consecutive 5-year periods to assess survival changes over time. Pathology data of patients who survived beyond 10 years was re-examined by two or more pancreatic pathologists. Results: Among 5553 resected PDAC patients (2000–2020), estimated 10-year OS was 10.6 % with significant improvement across 5-year periods (P < 0.001). Actual 10-year OS after resection was reached by 179 patients (7.3 %). Review of available pathology reports (n = 173) revealed another diagnosis than PDAC (misregistration) in 21 patients (12.1 %). Of the remaining 152 patients, tissue could be retrieved for 108 patients (71.1 %), of whom 21 (19.4 %) had a different diagnosis after pathological re-examination (misclassification). Alternative diagnoses were benign (i.e., pancreatitis), premalignant (i.e., non-invasive IPMN), or other malignancies (i.e., distal cholangiocarcinoma, ampullary, duodenal, or acinar cell carcinoma). Of the 87 patients with confirmed PDAC, 12 patients (13.8 %) had a histological subtype other than conventional (classic) PDAC (e.g., adenosquamous or colloid carcinoma). After excluding the 42 misregistered or misclassified patients (24.3 %), the true observed 10-year OS after resection of PDAC was 5.3 %. Conclusion: The observed 10-year OS after resection of PDAC in a nationwide cohort was only 5.3 % after pathological re-examination.
KW - Long-term survival
KW - Pancreatic ductal adenocarcinoma
KW - Pathology re-examination
UR - https://www.scopus.com/pages/publications/105021094751
U2 - 10.1016/j.ejca.2025.116099
DO - 10.1016/j.ejca.2025.116099
M3 - Article
C2 - 41207183
AN - SCOPUS:105021094751
SN - 0959-8049
VL - 231
JO - European Journal of Cancer
JF - European Journal of Cancer
M1 - 116099
ER -