Gudjonsson Birgir
The Medical Clinic, Álfheimum 74, 104 Reykjavik, Iceland.
HPB Surg. 2016;2016:6839687. doi: 10.1155/2016/6839687. Epub 2016 Oct 25.
. The incidence of pancreatic cancer is estimated to be 48,960 in 2015 in the US and projected to become the second and third leading causes of cancer-related deaths by 2030. The mean costs in 2015 may be assumed to be $79,800 per patient and for each resection $164,100. Attempt is made to evaluate the results over the last 80 years, the number of survivors, and the overall survival percentage. . Altogether 1230 papers have been found which deal with resections and reveal survival information. Only 621 of these report 5-year survivors. Reservation about surgery was first expressed in 1964 and five-year survival of nonresected survivors is well documented. . The survival percentage depends not only on the number of survivors but also on the subset from which it is calculated. Since the 1980s the papers have mainly reported the number of resections and survival as actuarial percentages, with or without the actual number of survivors being reported. The actuarial percentage is on average 2.75 higher. Detailed information on the original group (TN), number of resections, and actual number of survivors is reported in only 10.6% of the papers. Repetition occurs when the patients from a certain year are reported several times from the same institution or include survivors from many institutions or countries. Each 5-year survivor may be reported several times. . Assuming a 10% resection rate and correcting for repetitions and the life table percentage the overall actual survival rate is hardly more than 0.3%.
2015年美国胰腺癌的发病率估计为48960例,预计到2030年将成为癌症相关死亡的第二和第三大主要原因。2015年每位患者的平均费用可能为79800美元,每次手术切除费用为164100美元。本文试图评估过去80年的治疗结果、幸存者数量以及总生存率。总共发现了1230篇涉及手术切除并揭示生存信息的论文。其中只有621篇报告了5年幸存者情况。1964年首次有人对手术提出保留意见,未接受手术切除的幸存者的5年生存率有充分记录。生存率不仅取决于幸存者的数量,还取决于计算生存率的亚组。自20世纪80年代以来,论文主要报告手术切除数量和精算生存率百分比,有的报告了实际幸存者数量,有的则未报告。精算生存率百分比平均高出2.75。只有10.6%的论文报告了原始组(TN)、手术切除数量和实际幸存者数量的详细信息。当同一年的患者在同一机构被多次报告,或者包括来自多个机构或国家的幸存者时,就会出现重复情况。每一位5年幸存者可能会被多次报告。假设手术切除率为10%,并对重复情况和生命表百分比进行校正,总体实际生存率几乎不超过0.3%。