Long-Term Survivors of Pancreatic Cancer

Abstract

Objectives Pancreatic cancer continues to carry a poor prognosis with survival rates that have had minimal improvement over the past four decades. We report a population-based, comprehensive analysis of long-term survivors of pancreatic adenocarcinoma diagnosed in the diverse population of California. Methods Data from the California Cancer Registry were used to evaluate long-term survival. A total of 70,442 patients diagnosed with pancreatic adenocarcinoma between 1988 and 2009 were identified. Logistic regression was used to identify factors associated with achieving five-year survival. Results The overall five-year survival was 2.5%, with minimal incremental improvements throughout the three decades. Age, stage, degree of differentiation, and surgical resection were associated with five-year survival. Furthermore, younger age and receiving care at a National Cancer Institute-designated cancer center were similarly correlated with five-year survival regardless of surgical intervention. Additionally, we identified stage, differentiation, and adjuvant chemotherapy as significant factors for long-term survival in surgically resected patients. In the unresectable patients, Asian/Pacific Islanders and Hispanics were significantly more likely to reach the five-year milestone than non-Hispanic Whites. Conclusions Although pancreatic cancer mortality remains high, our study highlights baseline characteristics, treatment, biological factors and ethnicity that are associated with long-term survival. These findings may serve as a springboard for further investigation.

Ubiquitin specific peptidase 5 enhances STAT3 signaling and promotes migration and invasion in Pancreatic Cancer

“…Univariate and multivariate analyses demonstrated that high USP5 expression is an independent risk factor for pancreatic cancer. Our results also showed that differentiation is an unfavorable independent risk factor for pancreatic cancer, which have been proved by previous study 25 . In short, patients with high USP5 expression tend to have a poor prognosis, which is consistent with publicly databases.…”

Upregulation of CD20 Positive B-Cells and B-Cell Aggregates in the Tumor Infiltration Zone is Associated with Better Survival of Patients with Pancreatic Ductal Adenocarcinoma

“…Most patients with PDAC remain asymptomatic until the disease develops to an advanced inoperable stage, leading to its disappointing prognosis [4].The determination of prognostic factors in patients with PDAC is essential for predicting the outcome and for identifying appropriate treatment strategies. Known clinical prognostic parameters include age, tumor stage, lymph node status, grading, perineural invasion, and for resected patients' resection status, adjuvant chemotherapy and hospital volume [5][6][7].Moreover, it has long been recognized that the tumor microenvironment and an involvement of the immune system play a distinctive role in the biological behavior of cancer [8]. PDACs are characterized by an immunosuppressive microenvironment due to the dysfunction of the immune system, which is a result of the involvement of multiple types of immune cells, including cancer-associated fibroblasts, regulatory T cells, myeloid-derived suppressor cells, tumor-associated macrophages, and tumor-infiltrating lymphocytes [9].…”

“…The determination of prognostic factors in patients with PDAC is essential for predicting the outcome and for identifying appropriate treatment strategies. Known clinical prognostic parameters include age, tumor stage, lymph node status, grading, perineural invasion, and for resected patients' resection status, adjuvant chemotherapy and hospital volume [5][6][7].…”

Conditional Survival After Resection for Pancreatic Cancer: A Population-Based Study and Prediction Model

“…CS was defined as the probability of surviving an additional number of 'y' years, given that a patient had already survived for 'x' years, and was calculated as CS (x|y) = S (x?y) /S (x) , with S (x) representing the overall survival at x years estimated using the Kaplan-Meier method. 12 For example, to estimate the CS for surviving 2 more years for patients who had already have survived 3 years after surgery, CS (3|2) is calculated by dividing the 5-year Kaplan-Meier survival estimate S (5) by the 3-year Kaplan-Meier survival estimate S (3) . 8,[19][20][21] Median CS was also determined at specific times and was derived from Kaplan-Meier estimates by discarding the patients who died before that time.…”

“…1,2 Approximately 16% of all patients will undergo surgical resection, with a 5-year survival rate of 15-20%. [3][4][5] Survival following resection of pancreatic cancer has improved because of better adjuvant treatment strategies. 6,7 Therefore, increasing numbers of patients with pancreatic cancer will survive the first year following surgery and these patients might want to be informed about accurate data on survival estimates during follow-up.…”