Pancreatic cancer: Incidence, treatment and survival trends – 1175 cases in Calvados (France) from 1978 to 2002

Temporal Trends in Pancreatic Cancer

“…These changes were accompanied by a lowering percentage of gastro-enteric bypass from 33.8% to 22.8%. Lefebvre et al reported a similar decreasing trend for palliative surgery from 55% in 1978-1982 to 32% in 1998-2002 due to the more common use of endoscopic stenting (Lefebvre et al, 2009). We have found analogical variations in biliary bypass from 52% to 7%, but as opposed to Linder et al the percentage of gastro-enteric and simultaneous biliary and enteric bypasses increased from 4% to 26% and from 8% to 36%, respectively.…”

“…Simultaneous development of endoscopic methods allows to perform biliary or duodenal stenting, and along with better imaging tests, has contributed to the decreasing rates of open surgery in patients with disseminated disease (Lefebvre et al, 2009).…”

“…Results of our studies showed that any gemcitabine based regimen of palliative chemotherapy produced better results than observed in control groups and the combination of gemcitabine and cisplatin was the most effective regimen (Popiela et al, 2001;Popiela et al, 2005). Increased rates of adjuvant and palliative chemotherapy have been reported by several authors (David et al, 2009;Lefebvre et al, 2009). …”

A Meta-Analysis of Randomized Trials: Immediate Stent Placement vs. Surgical Bypass in the Palliative Management of Malignant Biliary Obstruction

“…5, 6 Since the late 1970s, endoscopic management of biliary obstruction has been increasingly used, rather than open abdominal surgical procedures. 7, 8 But the recent literature has suggested that biliary stent placement, followed by a planned surgical biliary bypass for curative resection after metabolic correction, may be associated with worse outcomes than early or immediate surgical biliary bypass. 9 Up to 50% of patients with unresectable pancreatic cancer eventually require an intervention for gastric outlet obstruction as well.…”

Metastatic pancreatic cancer: old drugs, new paradigms

“…It is the fourth leading cause of cancer death in the US, with about 43 140 new cases in 2010 [1]. Up to 85% of patients are diagnosed at a stage that the tumor is unresectable because of extension to the regional arteries or metastases [2,3 ]. Despite all efforts at developing effective therapy, prognosis for patients with metastatic pancreatic adenocarcinoma (MPA) is poor, with median survival of 2-4 months with supportive care alone [4,5,6 ].…”