Pancreatic adenocarcinoma: the actual 5-year survivors.
BACKGROUND
Most reports of patients undergoing resection for pancreatic adenocarcinoma report estimated (actuarial) 5-year survival rates. Actual 5-year survival is rarely described, and factors associated with long-term survival are not well described.


METHODS
Review of a prospectively maintained database identified 618 patients who underwent resection for pancreatic adenocarcinoma between 1/1983-1/2001. Patient, tumor, and treatment-related variables were assessed for their association with 5-year survival.


RESULTS
There were 75 patients who survived >5 years after resection (75 out of 618, 12%), and 18 patients who survived >10 years (18 out of 352, 5%). Patient age, gender, and tumor location were not associated with 5-year survival, whereas early American Joint Committee on Cancer (AJCC) stage (p < 0.001) and negative margins (p = 0.001) were associated with 5-year survival. Patients with stage IA disease had an actual 5 year survival of 26%. Median follow-up was 108 months. Recurrent disease developed in 38 patients (51%) and all died from disease. Adjuvant therapy was received by 21% (16 out of 75), and tumors were moderately differentiated in 58% (42 out of 75) and had a median size of 2.8 cm (0.8-13 cm).


CONCLUSIONS
Actual 5-year survival after resection of pancreatic adenocarcinoma was 12%. AJCC stage and negative margins were the only significant predictors of long-term survival. Early detection and intervention for patients with pancreatic cancer is crucial.
Ferrone
Cristina R
CR
Department of Surgery, Memorial Sloan-Kettering Cancer Center, Howard 1223, 1275 York Avenue, New York, NY 10021, USA.
Brennan
Murray F
MF
Gonen
Mithat
M
Coit
Daniel G
DG
Fong
Yuman
Y
Chung
Sun
S
Tang
Laura
L
Klimstra
David
D
Allen
Peter J
PJ
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D012737:Sex Factors; D015996:Survival Rate