title: Postresection survival outcomes of pancreatic cancer according to demographic factors and socio-economic status.
abstract: OBJECTIVE
  Aim of the study was to evaluate the impact of demographic factors (DGF) and socio-economic status (SES) on survival after pancreatic cancer resection in a German setting.
  
  
  METHODS
  Patients with pancreatic adenocarcinoma and pancreaticoduodenectomy were identified from our pancreatic resection database (1989-2008). DGF, SES, survival and tumor-related information were obtained from hospital records, a registry office questionnaire, and telephone interviews with patients, relatives and general practitioners.
  
  
  RESULTS
  Follow-up was completed in 117 patients. Median overall survival and 5-year survival rate was 22 month and 10%, respectively. Survival significantly improved over time with a 16% 5-year survival and a median survival of 27 month for recent patients. The longest survival period with a median of 63 month was observed for patients with AJCC stage I. Tumor-related factors and treatment period, but not SES influenced survival after pancreatic cancer resection in our cohort.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to explore survival from pancreatic cancer according to DGF and SES in a German setting. Disparities in survival among our patients depend solely on tumor-related factors and treatment period and could not be explained by SES including key factors like income or type of health insurance. The comparable postresection outcome of patients with low and high SES at our department could be in part due to the universal German multi-payer health system, based on compulsory enrolment for the majority, which seems not to support health care inequalities seen in other OECD countries.
authors.affiliation: Department of Surgery, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany.
authors.forename: Y
authors.initials: Y
authors.lastname: Kuhn
authors.forename: A
authors.initials: A
authors.lastname: Koscielny
authors.forename: T
authors.initials: T
authors.lastname: Glowka
authors.forename: A
authors.initials: A
authors.lastname: Hirner
authors.forename: J C
authors.initials: JC
authors.lastname: Kalff
authors.forename: J
authors.initials: J
authors.lastname: Standop
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D012923:Social Class; D016019:Survival Analysis; D016896:Treatment Outcome