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Pancreatic Cancer Surgery Survival Rates

Patient Demographics And Preoperative Parameters

What is the Survival Rate of Pancreatic Cancer?

From 1993 to 2008, 195 patients underwent pancreatic head resections due to ductal adenocarcinoma of the pancreas at our institution. The patients were observed from 1993 to 2011. The patient characteristics are described in Table. An obstructive jaundice appeared on average 4weeks before the operation in 159 patients , and 139 of the patients were preoperatively treated with a biliary stent . The maximal bilirubin concentration was 17.26mg/dl . Weight loss was observed in 119 patients, and the average preoperative weight loss was 8.55kg . The average onset of weight loss was 8.0weeks before the operation .

Factors That Influence Survival

Cancer registries base five-year survival rates on everyone with the diagnosisregardless of age, health, or cancer type. Any one patients actual risk of getting pancreatic cancer, as well as their survival after treatment, will be dictated by other factors. Some of those factors can be changed, while others cant.

  • Age: Older patients fare worse than younger patients.
  • Race:The pancreatic cancer rate is considerably higher for Black people than for any other race.
  • Cancer types: Different cells in the pancreas give rise to tumors that react differently to treatments. These include neuroendocrine tumors, small cell carcinoma, squamous cell carcinoma, adenocarcinoma, and primary pancreatic lymphoma.
  • Smoking:Tobacco use is a risk factor for developing pancreatic cancer. If no one smoked, there would be 30% fewer pancreatic cancers.
  • Alcohol:Heavy drinkers have a worse prognosis than those who dont drink or drink less.
  • Obesity: Excess weight before the age of 50 is correlated with increased pancreatic cancer risk.
  • Diabetes: People with diabetes have worse survival when diagnosed with pancreatic cancer.
  • Performance status:This measure of a patients ability to perform daily tasks is one of the best indicators of prognosis. The more trouble everyday tasks are, the worse off the patient is.
  • Surgery:If the doctor can cut the whole tumor out, the patient has a much better outlook.

Prognosis Depends On Stage At Diagnosis

Long-term prognosis for pancreatic cancer depends on the size and type of the tumor, lymph node involvement and degree of metastasis at the time of diagnosis. The earlier pancreatic cancer is diagnosed and treated, the better the prognosis.

Unfortunately, pancreatic cancer usually shows little or no symptoms until it has advanced and spread. Therefore, most cases are diagnosed at later, more difficult-to-treat stages.

Read more about pancreatic cancer staging.

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Access To Pancreatic Cancer Treatment

Surgery is the only treatment with curative intent for pancreatic cancer while chemotherapy and radiotherapy have also been shown to improve survival in late stage pancreatic cancer. However, most people with pancreatic cancer will receive no active treatment .

7 in 10 people with pancreatic cancer do not receive any active treatment.

1 in 10 people with pancreatic cancer will receive potentially curative surgery.

2 in 10 people will receive chemotherapy.

Results Of Univariate And Multivariate Analyses

Pancreatic Cancer Survival rates in England increase significantly in ...

In the univariate analysis, stratification factors, such as race, sex, year of diagnosis, pathological grade, AJCC stage, historic stage, tumour location, and age were used to evaluate PCSS and calculate the five-year PCSS. All of these factors, except sex, were significantly associated with PCSS .

In multivariate analysis, all significant stratification factors were included in the Cox model . Race and sex were not found to be prognostically important for assessing the survival of PC patients. Additionally, recent diagnosis of PC was found to be associated with a better survival than diagnosis in previous years. Undoubtedly, PC patients with tumours of higher grades had a higher risk of death than did those with tumours of pathological grade I/II. Likewise, advanced PC patients in stage III/IV or with distant organ involvement had a much poorer prognosis than did those outside this grouping. Compared with tumours in the head, tumours localized in the body and tail of the pancreas appeared to be associated with a favourable prognosis. Finally, the mortality risk of PC patients aged between 40 and 80 years was twice that of the patients aged below 40 years. However, patients aged > 80 years had a mortality risk three times higher than that of patients aged < 40 years. Therefore, age was an independent factor for predicting the prognosis of PC patients.

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Pancreatic Cancer Stage 0

This is the earliest stage of pancreatic cancer, though it may not necessarily involve cancer. It just means that abnormal cells have been detected, and they could potentially become cancerous in the future. This stage doesnt involve any symptoms.

Treating pancreatic cancer involves two main goals: to kill cancerous cells and prevent the cancer from spreading. The most appropriate treatment option will depend on the stage of the cancer.

The main treatment options include:

  • Surgery. Surgical treatment of pancreatic cancer involves removing portions of the pancreas . While this can eliminate the original tumor, it wont remove cancer thats spread to other areas. As a result, surgery usually isnt recommended for advanced-stage pancreatic cancer.
  • Radiation therapy. X-rays and other high-energy beams are used to kill cancer cells.
  • Chemotherapy. Anticancer drugs are used to kill cancer cells and help prevent their future growth.
  • Targeted therapy. Medications and antibodies are used to individually target cancer cells without harming other cells, which can happen with chemotherapy and radiation therapy.
  • Immunotherapy. Various methods are used to trigger your immune system to target the cancer.

In some cases, a doctor might recommend combining multiple treatment options. For example, chemotherapy might be done before surgery.

For advanced-stage pancreatic cancer, treatment options might focus more on pain relief and keeping symptoms as manageable as possible.

What Is The Five

In the U.S., the overall five-year relative survival rate for pancreatic cancer is 9%, meaning that about nine out of 100 patients will still be alive five years after their diagnosis. This rate refers to all stages and types of pancreatic cancer diagnoses. However, survival rates do vary between stages and according to other factors, such as age, overall health, and location of the primary tumor within the pancreas.

Pancreatic tumors can be exocrine or endocrine, depending on the type of pancreas cell where they start. The most common type of pancreatic cancer is an exocrine form known as adenocarcinoma. Pancreatic neuroendocrine tumors are of the endocrine type and are much rarer, but typically have a better prognosis.

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Pancreatic Cancer Survival Rates

Pancreatic cancer survival rates are based on groups, but you are an individualand every patients situation is unique. The National Cancer Institutes Surveillance, Epidemiology, and End Results Program tracks five-year survival rates for all types of cancer based on data from previous patients and sometimes older treatments.

Based on people diagnosed with prostate cancer between 2011 and 2017, SEER data shows:

  • Localized prostate cancer that is contained within the pancreas has a five-year relative survival rate of 41.6 percent.
  • Regional cancer that has spread from the pancreas into nearby parts of the body, such as the lymph nodes, has a five-year relative survival rate of 14.4 percent.
  • Distant cancer that has spread to farther parts of the body, such as the liver or lungs, has a five-year relative survival rate of 3 percent.
  • The overall five-year relative survival rate for pancreatic cancer is 10.8 percent.

Its important to remember that survival rates are constantly improving, so patients diagnosed now typically have better outcomes than those diagnosed in the past.

Survival Rates By Stage

Whipple Procedure Survival Rate/Pancreatic Cancer Surgery

If youve been diagnosed and your stage has been determined, you may be curious about your outlook. An outlook is based on information compiled from people who have a similar cancer.

Although theyre useful, survival statistics arent definitive. Make sure you discuss your individual outlook with your doctor so you can better understand what it means for you.

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Variation In Pancreatic Cancer Treatment And Care

Depending on where someone diagnosed with pancreatic cancer receives care, their experience can be very different there can be different diagnostic pathways, different standards of care and different approaches to treatment.

Geographically, variation in treatment and care exists at all levels. There is international survival variation across developed countries, regional treatment variation across Cancer Alliances, and local variation in clinical practice between hospitals.

Survival For Pancreatic Endocrine Tumours

Pancreatic endocrine tumours are an uncommon type of pancreatic cancer. More recently doctors have been calling them neuroendocrine neoplasms . This is an umbrella term for this group of disorders. Then they are called either neuroendocrine tumours or neuroendocrine carcinomas . This depends on how slow or fast growing the cells are.

They generally have a better outlook than adenocarcinoma of the pancreas.

1 year survival

The information below is for 1 year overall survival for pancreatic neuroendocrine neoplasms in the UK.

Around 80 in 100 people survive for 1 year or more.

5 year survival

There are no UK-wide 5 year survival statistics available for pancreatic NENs. The statistics below are from a European study. Please be aware that these figures may not be a true picture of survival in the UK. This is due to differences in health care systems, data collection and the population,

Around 40 out of 100 people survive their cancer for 5 years or more after diagnosis.

British Journal of Cancer Volume 121, pages 966972

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Better Prognosis For Resectable Tumors

Patients whose tumors are found before they have metastasized or become locally advanced tend to have longer survival rates, on average, because their tumors can usually be resected .

About 15 to 20 percent of all pancreatic tumors are resectable. These include stage I and stage II tumors. Rarely, locally advanced stage III tumors, which are typically considered unresectable , are characterized as borderline and may be removed if the patient has access to an experienced, highly trained surgeon.

Tumors can still grow back in many patients. So, on average, patients whose tumors were resected live for 2.5 years after their diagnosis and have a five-year survival rate of 20 to 30 percent.

What Are The Steps Of The Whipple Procedure

Pancreatic cancer statistics

The Whipple procedure can be summed up in a few steps:

  • A large incision will be made in your abdomen .
  • Your surgeon will remove the portion of your pancreas where the tumor is located along with the small bowel surrounding it , the lower section of the bile duct, the gall bladder and sometimes a part of your stomach.
  • Whats left of your pancreas and bile duct get attached to your small intestine.
  • The small intestine is then reattached to your stomach, ensuring that food can pass through the entire digestive tract.
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    Survival Rates For Pancreatic Neuroendocrine Tumor

    Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

    Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Your doctor is familiar with yoursituation ask how these numbers may apply to you.

    Borderline Resectable Pancreatic Cancer

    Depending on the location of stage 2A, stage 2B and stage 3 pancreatic cancers, treatment often involves resection in combination with neoadjuvant treatment to shrink the tumor before surgery takes place. Borderline resectable pancreatic cancer has grown into nearby tissues, organs or a major blood vessel. Although it may be possible to remove the tumor, surgeons may not be able to extract all of the cancer via surgery. Adjuvant treatment via chemotherapy or radiation may be performed after surgery to help destroy remaining cancer cells.

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    What Happens Before The Whipple Procedure

    If you have cancer, you may go through radiation or chemotherapy before you have the surgery.

    Your surgeon will instruct you to stop taking certain medications in the days leading up to your surgery. You should also:

    • Avoid food and drinks for eight hours before going to the hospital for your Whipple procedure, unless directed otherwise.
    • Quit smoking even if its just for two weeks before the Whipple procedure to improve heart and lung health.
    • Stop taking herbal supplements for one to two weeks before the surgery as directed by your healthcare provider.
    • Not take Viagra® or other medications for erectile dysfunction at least 24 hours before a Whipple procedure.
    • You should take certain blood pressure medications with a sip of water as instructed by your provider.

    Once at the hospital, your nurse will insert an intravenous line into your arm to inject fluids and medications youll need during the surgery. Additionally, an epidural catheter or spinal injection may be necessary. They block your nerves, helping decrease pain after surgery.

    What Is Locally Advanced Pancreatic Cancer

    Pancreatic cancer survival rates ‘completely unacceptable’

    Locally advanced pancreatic cancer is considered stage 3 cancer. It is cancer that has spread beyond the pancreas, typically to large blood vessels near the pancreas or to nearby lymph nodes. In most cases, the cancer is too advanced to be fully removed. Treatment for locally advanced pancreatic cancer is highly individualized based on the patients overall health, tumor spread and personal desires, but may include:

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    Pancreatic Cancer Stage 4

    Stage 4 pancreatic cancer has spread beyond the original site to distant sites, like other organs, the brain, or bones.

    Pancreatic cancer is often diagnosed at this late stage because it rarely causes symptoms until it has spread to other sites.

    Symptoms you might experience at this stage include:

    • pain in the upper abdomen
    • pain in the back
    • fatigue
    • depression

    Stage 3 pancreatic cancer is difficult to cure, but treatments can help prevent the spread of the cancer and ease symptoms. These treatments may include:

    The majority of people with this stage of the cancer will have a recurrence. Thats likely due to the fact that micrometastases, or small areas of undetectable cancer growth, have spread beyond the pancreas as the time of detection and arent removed during surgery.

    Anatomic Site Functional Performance Status

    The anatomic distribution of all stages of pancreatic cancer and MPC are detailed in Figure 2. Of note, while the head of the pancreas constitutes 6,506 cases of all cancers identified, only 2,656 cases originated at this site among patients with MPC. The tail of the pancreas constituted 4.6% more cases of MPC compared to pancreatic cancer at all stages.

    Figure 2

    The functional performance status as calculated by the ECOG-PS score is shown in Figure 3 for all stages. The other established system of ranking performance status, the Karnofsky Performance Status was used in a negligible number of charts. The functional status appears to trend down as the stage at diagnosis advances. For example, 36.41% of stage I patients have a functional ECOG-PS score of 0 while only 20% of stage IV patients have an ECOG-PS of 0. For stage I patients, 7.04% of patients had an ECOG-PS score of 3, and 14.39% of patients diagnosed at stage IV had this ECOG-PS score.

    Figure 3

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    Pancreatic Cancer Stage 1

    Stage 1 pancreatic cancer involves a tumor thats only in the pancreas. This stage is divided into two subcategories, depending on the size of the tumor:

    • Stage 1A. The tumor measures 2 cm or less.
    • Stage 1B. The tumor measures more than 2 cm but less than 4 cm.

    Stage 1 pancreatic cancer typically doesnt cause any noticeable symptoms.

    If detected at this stage, pancreatic cancer may be curable with surgery.

    How Does Survival Rate Depend On Stage At Diagnosis

    Pancreatic Cancer Survival Rate

    Fiveyear pancreatic cancer relative survival rates are 37% for patients with localized disease , 12% for patients with regional disease , and 3% for those with distant pancreatic cancer. Pancreatic cancer is most often diagnosed at an advanced stage 53% of patients are diagnosed with stage 4 pancreatic cancer, whereas only 10% of patients are diagnosed at the early stage when surgery is possible. Because the majority of patients are diagnosed at stage 4, which has the lowest survival rate, the overall survival rate for all stages is 9%lower than the average survival rate of all the stages.

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    How Are Survival Rates Determined

    In the United States, cancer survival rates are calculated with data collected by the National Cancer Institutes Surveillance, Epidemiology, and End Results program. SEER collects data on all types of cancers from different geographical locations and sources throughout the country. While it is not yet feasible to obtain data for every single patient in the U.S., SEER data covers large proportions of the countrys population and can be statistically analyzed to make reasonably accurate estimates of overall cancer survival rates.

    The SEER program began collecting cancer data in 1973 in seven cancer registriessystems for collecting and managing cancer datarepresenting five states and two metropolitan areas. Since then, more registries representing different geographical locations have been added, and to date, 21 registries have collected cancer data through SEER. Different databases represent groups of these registries in different combinations used to analyze survival data and other statistics.

    Sometimes survival rates vary slightly based on the SEER database used. For example, pancreatic cancer five-year survival is reported to be 10% when using the SEER 9 database which contains 9 registries and represents about 9% of the U.S. population, but it is reported to be 9% when using SEER 18, which contains 18 registries and represents about 28% of the population.

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