title: Nationwide improvement of only short-term survival after resection for pancreatic cancer in the Netherlands.
abstract: OBJECTIVE
  Evaluation of incidence, treatment, and survival trends after resection of pancreatic cancer at a national level.
  
  
  METHODS
  Using data on patient and tumor characteristics from the nationwide Netherlands Cancer Registry trends were analyzed for the period 1989-2008.
  
  
  RESULTS
  A total of 30,025 patients diagnosed with pancreatic cancer were included. The incidence remained stable over the 20-year study period at approximately 9 per 100,000 inhabitants. Resection rates increased from 8% in 1989 to 12% in 2008, adjuvant chemotherapy rates increased from 7% to 29%, and palliative chemotherapy rates increased from 5% to 19% (P < 0.0001 each). Relative survival proportions did not change over time; besides a minimal, nonsignificant increase at 3 months from 53% to 55%, these remained 34% at 6 months and 4.5% at 3 years. Among the patients undergoing tumor resection, relative survival increased from 82% to 93% at 3 months and from 51% to 63% at 1 year after diagnosis. However, no improvement was seen after 3 years (23%).
  
  
  CONCLUSIONS
  The increased short-term survival among patients who underwent resection probably reflects decreased postoperative mortality driven by ongoing centralization efforts. However, longer-term survival remained poor irrespective of the changes in management in the past decades.
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. s.nienhuijs@hccnet.nl
authors.forename: Simon W
authors.initials: SW
authors.lastname: Nienhuijs
authors.forename: Sanne A
authors.initials: SA
authors.lastname: van den Akker
authors.forename: Esther
authors.initials: E
authors.lastname: de Vries
authors.forename: Ignace H
authors.initials: IH
authors.lastname: de Hingh
authors.forename: Otto
authors.initials: O
authors.lastname: Visser
authors.forename: Valery E
authors.initials: VE
authors.lastname: Lemmens
mesh_terms: D000367:Age Factors; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012737:Sex Factors; D015996:Survival Rate