Improvement in treatment and outcome of pancreatic ductal adenocarcinoma in north China.

backgroundThe incidence of pancreatic cancer has increased in China in the last decade, though efforts have been made in early detection and multimodality treatment. The aim of this study is to describe the decade-based development in early diagnosis and treatment modalities, as well as outcome for patients with pancreatic ductal adenocarcinoma (PDAC) in a high-volume facility.

methodsAll the PDAC patients underwent surgery between 1991 and 2009 and were selected from the database of TianJin Cancer Institute and Hospital. Decade-based changes in early diagnosis, treatment modalities, and outcome of the patients were retrospectively analyzed.

resultsOf the 565 patients with PDAC, patients in this decade (n = 460) had better overall survival than those in the last decade (n = 105), median survival was 10 months and 3 months, respectively. Patients in this decade had significantly improved in (P < 0.001) 2-year (14.7%) and 5-year survival rates (3.5%) as compared to those in the last decade (6.7% and 3.4%, respectively). Patients with metastasis at diagnosis in the last decade and this decade were 54% and 26% (P < 0.001), respectively. More patients in this decade had underwent R0/R1 resection (33% vs 20%, P = 0.010), chemotherapy (37% vs 12%, P < 0.001), and radical resection (34% vs 21%, P = 0.014) than those in the last decade.

conclusionPatients operated on for PDAC in this decade had a better outcome than those in the last decade. Early detection, improved resection margin, and development in multimodality treatment contribute to this improvement.