title: Does long-term survival exist in pancreatic adenocarcinoma?
abstract: BACKGROUND
  We conducted a population-based study to investigate long-term survival in patients diagnosed with a (suspected) pancreatic adenocarcinoma.
  
  
  METHODS
  All patients diagnosed with a pancreatic adenocarcinoma or with a pathologically unverified tumour of the pancreas between 1993 and 2008 in the South of the Netherlands were selected from the Netherlands Cancer Registry (NCR). Medical charts of patients who were alive five years or longer since diagnosis were reviewed.
  
  
  RESULTS
  A total of 2 564 patients were included, of whom 1 365 had a pancreatic adenocarcinoma and 1 199 had a pathologically unverified pancreatic tumour. Five-year survival of patients with pathologically verified adenocarcinomas was 1.7% (24 of 1 365 patients). Twenty-one-one of these 24 long-term survivors were among the 207 cases that underwent surgical resection as initial treatment; five-year survival after resection thus being 10.1%. Half of the long-term survivors who underwent surgical resection still eventually died of recurrent disease. Five-year survival among patients with clinically suspected but microscopically unverified pancreatic tumours was 1.3% (16 of 1 199 patients). In 15 of these 16 long-term survivors the initial clinical diagnosis was revised: 14 had benign disease and one a premalignant tumour.
  
  
  CONCLUSIONS
  Long-term survival among patients with pancreatic adenocarcinoma is extremely rare. As long-term survival in clinically suspected but pathologically unverified cancer is very unlikely, repeated fine needle aspiration or, preferably, histological biopsy is recommended in order to establish an alternative diagnosis in patients who survive longer than expected (more than 6-12 months).
authors.affiliation: a Department of Internal Medicine , Medical Oncology, Catharina Hospital , Eindhoven , The Netherlands ;
authors.forename: Myrte
authors.initials: M
authors.lastname: Zijlstra
authors.affiliation: a Department of Internal Medicine , Medical Oncology, Catharina Hospital , Eindhoven , The Netherlands ;|b The Netherlands Cancer Registry, Comprehensive Cancer Organization the Netherlands , Utrecht , The Netherlands ;
authors.forename: Nienke
authors.initials: N
authors.lastname: Bernards
authors.affiliation: c Department of Surgery , Catharina Hospital , Eindhoven , The Netherlands ;
authors.forename: Ignace H J T
authors.initials: IH
authors.lastname: de Hingh
authors.affiliation: d Department of Internal Medicine , Medical Oncology, VieCuri Medical Center , Venlo , The Netherlands ;
authors.forename: Agnes J
authors.initials: AJ
authors.lastname: van de Wouw
authors.affiliation: e Department of Internal Medicine , Medical Oncology, TweeSteden Hospital , Tilburg , The Netherlands ;
authors.forename: Swan Hoo
authors.initials: SH
authors.lastname: Goey
authors.affiliation: f Department of Internal Medicine , Medical Oncology, Elkerliek Hospital , Helmond , The Netherlands ;
authors.forename: Esther M G
authors.initials: EM
authors.lastname: Jacobs
authors.affiliation: b The Netherlands Cancer Registry, Comprehensive Cancer Organization the Netherlands , Utrecht , The Netherlands ;|g Department of Public Health , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
authors.forename: Valery E P P
authors.initials: VE
authors.lastname: Lemmens
authors.affiliation: a Department of Internal Medicine , Medical Oncology, Catharina Hospital , Eindhoven , The Netherlands ;
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Creemers
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009426:Netherlands; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*