Has survival improved following resection for pancreatic adenocarcinoma?


      • This study was undertaken to determine if survival after resection of pancreatic adenocarcinoma has improved.
      • The SEER database was queried for patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1992–2010.
      • From 1992–2010, patients lived more years but without improved 5-year survival.



      This study was undertaken to determine if survival after resection of pancreatic adenocarcinoma has improved over the past two decades.


      The SEER database was queried for patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1992 to 2010. AJCC Stage and survival were determined for patients. Data were analyzed using Mantel-Cox test and linear regression.


      15,604 patients underwent pancreatectomy from 1992 to 2010. Survival improved from 1992 to 2010 (p < 0.0001); specifically, median survival increased 1992–2010 (p < 0.0001). However, 5-year survival rates did not change 1992–2010. More patients (p = 0.007) underwent resections of Stage I and relatively more patients (p = 0.004) underwent resections of Stage II cancers 2004–2010 with commensurately smaller tumors (p = 0.01).


      From 1992 to 2010, progressively more patients underwent pancreatectomy for pancreatic adenocarcinoma with progressively smaller tumors and earlier stages. These patients lived more years (e.g., improved survival curves and median survival) but without improved 5-year survival, denoting better early and intermediate survival. Early detection, better perioperative care, more efficacious noncurative chemotherapy undoubtedly play a role, but better solutions for long-term survival must be sought.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Nitecki S.S.
        • Sarr M.G.
        • Colby T.V.
        • van Heerden J.A.
        Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving?.
        Ann Surg. 1995; 221: 59-66
        • Conlon K.C.
        • Klimstra D.S.
        • Brennan M.F.
        Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors.
        Ann Surg. 1996; 223: 273-279
        • Allen P.J.
        Pancreatic adenocarcinoma: putting a hump in survival.
        J Am Coll Surg. 2007; 205: S76-S80
        • Kuhlmann K.F.
        • de Castro S.M.
        • Wesseling J.G.
        • et al.
        Surgical treatment of pancreatic adenocarcinoma; actual survival and prognostic factors in 343 patients.
        Eur J cancer (Oxford, Engl 1990). 2004; 40: 549-558
        • Yeo C.J.
        • Cameron J.L.
        • Sohn T.A.
        • et al.
        Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes.
        Ann Surg. 1997; 226 (discussion 57–60): 248-257
        • Wade T.P.
        • el-Ghazzawy A.G.
        • Virgo K.S.
        • Johnson F.E.
        The whipple resection for cancer in U.S. Department of veterans affairs hospitals.
        Ann Surg. 1995; 221: 241-248
        • Edge S.B.
        • Schmieg Jr., R.E.
        • Rosenlof L.K.
        • Wilhelm M.C.
        Pancreas cancer resection outcome in American University centers in 1989–1990.
        Cancer. 1993; 71: 3502-3508
        • Cleary S.P.
        • Gryfe R.
        • Guindi M.
        • et al.
        Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors.
        J Am Coll Surg. 2004; 198: 722-731
        • Kalser M.H.
        • Ellenberg S.S.
        Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection.
        Arch Surg. 1985; 120: 899-903
        • Burris 3rd, H.A.
        • Moore M.J.
        • Andersen J.
        • et al.
        Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial.
        J Clin Oncol. 1997; 15: 2403-2413
        • CostHelper I.
        Pancreatic Cancer Treatment Cost.
        2015 (Available from:)
        • Pancreatic Cancer Action I
        Pancreatic Cancer Research. Funding and Survival Comparisons with Other Cancers.
        2015 (Available from:)
        • American Cancer Society I
        What Are the Risk Factors for Pancreatic Cancer?.
        2015 (Available from:)
        • American Cancer Society I
        How Many People Get Pancreatic Cancer?.
        2015 (Available from:)
        • Howlader N.
        • Noone A.M.
        • Krapcho M.
        • et al.
        SEER Cancer Statistics Review, 1975–2011.
        National Cancer Institute, 2014
        • Chen S.C.
        • Shyr Y.M.
        • Wang S.E.
        Longterm survival after pancreaticoduodenectomy for periampullary adenocarcinomas.
        HPB Oxf. 2013; 15: 951-957
        • Mosca F.
        • Giulianotti P.C.
        • Balestracci T.
        • et al.
        Long-term survival in pancreatic cancer: pylorus-preserving versus whipple pancreatoduodenectomy.
        Surgery. 1997; 122: 553-566
        • Fabregat J.
        • Busquets J.
        • Pelaez N.
        • et al.
        Surgical treatment of pancreatic adenocarcinoma using cephalic duodenopancreatectomy (Part 2). Long term follow up after 204 cases.
        Cir Esp. 2010; 88: 374-382
        • Cameron J.L.
        • Pitt H.A.
        • Yeo C.J.
        • Lillemoe K.D.
        • Kaufman H.S.
        • Coleman J.
        One hundred and forty-five consecutive pancreaticoduodenectomies without mortality.
        Ann Surg. 1993; 217 (discussion 5–8): 430-435
        • Lewis R.
        • Drebin J.A.
        • Callery M.P.
        • et al.
        A contemporary analysis of survival for resected pancreatic ductal adenocarcinoma.
        HPB Oxf. 2013; 15: 49-60
        • Toomey P.
        • Hernandez J.
        • Golkar F.
        • Ross S.
        • Luberice K.
        • Rosemurgy A.
        Pancreatic adenocarcinoma: complete tumor extirpation improves survival benefit despite larger tumors for patients who undergo distal pancreatectomy and splenectomy.
        J Gastrointest Surg. 2012; 16: 376-381