Cumulative morbidity and late mortality in long-term survivors of exocrine pancreas cancer.
BACKGROUND
Less than 5% of patients diagnosed with exocrine pancreas cancer live to be long-term survivors (5+ years after diagnosis). As a result, few studies have focused on these patients' cumulative, cancer-related morbidity and late mortality. This descriptive study was undertaken to explore such issues.


METHODS
One thousand eight hundred thirty consecutive patients who had exocrine pancreas cancer had been seen at the Mayo Clinic between 1995 and 2001 and who had well-documented evidence of having lived for 5+ years were the focus of this study.


RESULTS
Only 85 patients (4.6%) met all the above criteria. These patients had a median age of 65 years with a slight female predominance (53%). Eighty-one (95%) were treated with surgery, 42 (49%) with chemotherapy, and 41 (48%) with radiation. Cumulative morbidity included one or more subsequent surgeries in 17 patients (20%), one or more major infections in 14 (16%), diabetes in 39 (45%), depression in 16 (19%), and a second malignancy in 17 (20%). Twenty-nine patients were deceased at the time of this report; 15 (18%) died from recurrent pancreas cancer more than 5 years after their original diagnosis.


CONCLUSIONS
Long-term survivors of exocrine pancreas cancer confront notable rates of cumulative morbidity, which include subsequent major surgeries, major infections, diabetes, depression, and second malignancies, as well as late deaths from pancreas cancer itself.
Jacobs
Nisha L
NL
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Que
Florencia G
FG
Miller
Robert C
RC
Vege
Santhi Swaroop
SS
Farnell
Michael B
MB
Jatoi
Aminah
A
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009017:Morbidity; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000628:therapy; D011878:Radiotherapy; D017741:Survivors / Q000706:statistics & numerical data*
D000970:Antineoplastic Agents