Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA.
Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA.
Am J Surg. 2019 Jan;217(1):103-107. doi: 10.1016/j.amjsurg.2018.05.017. Epub 2018 May 23.
We assessed trends in the clinical presentation, treatment, and survival for pancreatic adenocarcinoma.
A retrospective cohort study using data from the SEER program (2004-2014). All patients diagnosed with pancreatic adenocarcinoma over 2 eras were included (A: 2004-2009 vs. B: 2010-2014). Outcomes of interest were the likelihood of metastatic disease at diagnosis, utilization of resection, and overall survival.
A total of 62,201 patients were included in this study [Era B - 31,998 (51.4%)]. Patients diagnosed in Era B were significantly less likely to have metastatic pancreatic cancer at diagnosis, and demonstrated improved long-term survival after risk-adjustment. Similarly, patients with non-metastatic pancreatic cancer that were diagnosed in Era B were independently more likely to undergo resection. The observed association between era of diagnosis and survival was independent of resection status and the presence of metastatic disease.
There have been significant improvements in pancreatic cancer care over the last decade, as evidenced by earlier diagnosis, increased utilization of surgery, and improvement in overall survival for both resected and un-resected patients.
我们评估了胰腺腺癌的临床表型、治疗和生存趋势。
一项使用 SEER 计划（2004-2014 年）数据的回顾性队列研究。纳入了两个时期（A：2004-2009 年与 B：2010-2014 年）所有被诊断为胰腺腺癌的患者。感兴趣的结局包括诊断时转移性疾病的可能性、手术切除的利用以及总生存。
本研究共纳入 62201 例患者[B 期：31998 例（51.4%）]。B 期诊断的患者在诊断时患有转移性胰腺癌的可能性显著降低，且在风险调整后长期生存得到改善。同样，B 期诊断为非转移性胰腺癌的患者更有可能接受手术切除。诊断时的时期与生存之间的观察到的关联独立于手术切除状态和转移性疾病的存在。
在过去十年中，胰腺癌症的治疗取得了重大进展，表现为更早的诊断、手术切除的利用率增加，以及手术切除和未手术切除患者的总体生存率提高。
