Jonsdottir Sara B, Juliusson Gunnar, Kristinsson Jon Ö, Hreinsson Johann P, Jonasson Jon G, Björnsson Einar S
a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Landspitali University Hospital , Reykjavik , Iceland.
b Faculty of Medicine , University of Iceland , Reykjavik , Iceland.
Scand J Gastroenterol. 2018 Jan;53(1):100-106. doi: 10.1080/00365521.2017.1390598. Epub 2017 Oct 23.
Limited data exist on the changes in the epidemiology of pancreatic cancer and outcomes over the last decades in population-based cohorts. We aimed to compare the incidence of pancreatic cancer, diagnostic, treatment and survival among patients diagnosed over the period 1986-2009.
A retrospective, nationwide, population-based study. All patients diagnosed with pancreatic cancer in Iceland in two periods, 1986-1997 (P1) and 1998-2009 (P2) were identified through the Icelandic Cancer Registry and relevant clinical information obtained from medical records.
A total of 645 patients were identified, 296 in P1 and 349 in P2 (NS). The incidence during P1 was 6.8 per 100,000 inhabitants and 6.2 during P2 (NS). Among biopsy-proven cancers, adenocarcinoma was diagnosed in 89% of the cases in P1 and in P2 in 93% of the cases. Overall 38 (14%) in P1 underwent resection and 22 (7%) in P2 (p < .0004). Patients diagnosed in P2 had longer survival at 6 months (p = .015, log-rank test) and one year (p = .0206) after diagnosis. A total of 4/296 (1.4%) in P1 survived more than 5 years and 3/349 (0.9%) in P2 (NS).
The incidence among patients with pancreatic cancer in Iceland did not show major changes during the last 20 years. Diagnostic approach has changed considerably demonstrating more patients that are not 'resectable'. Survival rate at 6 months and one year has improved over the last two decades whereas the 5-year prognosis has not improved.
关于过去几十年基于人群队列中胰腺癌流行病学变化及预后的数据有限。我们旨在比较1986年至2009年期间确诊患者的胰腺癌发病率、诊断、治疗及生存情况。
一项回顾性、全国性、基于人群的研究。通过冰岛癌症登记处识别出在两个时期（1986 - 1997年（P1）和1998 - 2009年（P2））在冰岛被诊断为胰腺癌的所有患者，并从病历中获取相关临床信息。
共识别出645例患者，P1期296例，P2期349例（无统计学差异）。P1期发病率为每10万居民6.8例，P2期为6.2例（无统计学差异）。在活检确诊的癌症中，P1期89%的病例诊断为腺癌，P2期为93%。总体而言，P1期38例（14%）接受了手术切除，P2期22例（7%）（p < 0.0004）。P2期确诊的患者在诊断后6个月（p = 0.015，对数秩检验）和1年（p = 0.0206）的生存期更长。P1期共4/296（1.4%）患者存活超过5年，P2期为3/349（0.9%）（无统计学差异）。
冰岛胰腺癌患者的发病率在过去20年中未显示出重大变化。诊断方法有了很大改变，显示出更多患者“不可切除”。过去二十年中6个月和1年的生存率有所提高，而5年预后并未改善。
