Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Pancreatic Cancer UK, 3 Albert Embankment, Lambeth, London, SE1 7SP, UK.
Pancreatology. 2020 Apr;20(3):454-461. doi: 10.1016/j.pan.2020.01.012. Epub 2020 Jan 22.
The aim was to compare population-based survival for exocrine pancreatic cancer in England in the 23 regions covered by specialist centres. The centres were initiated in 2001, covering populations of 2-4 million.
We examined incidence for adults diagnosed with a pancreatic exocrine cancer during 1995-2014 and age-standardised net survival up to five years after diagnosis for patients diagnosed during 2000-2013. We examined variation in regional resection rates and survival for patients diagnosed during 2010-2013. The data were extracted from the National Cancer Registration and Analysis Service.
Age-standardised annual incidence rates of exocrine pancreatic cancer increased from 17.1 per 100,000 during 1995-1999 to 18.7 during 2010-2014. Age-standardised one-year and five-year net survival increased from 17.9% and 3.6%, respectively, for 2000-2009, to 21.6% and 4.2% during 2010-2013. There were 2086 (8.9%) resections among 23,415 patients diagnosed with an exocrine tumour in 2010-2013. The proportion ranged from 5.1% to 19.6% between centres. Among resected patients, survival was 73.0% at one year and 20.2% at five years. Of the total 2118 resected patients, 18 (0.9%) were at stage 1; 34 (1.6%) at stage 2; 791 (37.3%) at stage 3 and 140 (6.6%) at stage 4, although 53.6% of stage information was missing. Five-year survival was 2.1% for those who were not resected. The number of resections performed in each centre was not correlated with one-year survival.
Despite improvements in the management of pancreatic cancer in England with the introduction of specialist centres, resection rates remain relatively low, and survival remains lower than in comparably wealthy countries.
本研究旨在比较英格兰 23 个专科中心覆盖地区的外分泌胰腺肿瘤的人群生存率。这些中心成立于 2001 年，覆盖人群为 200 至 400 万。
我们调查了 1995 至 2014 年间成年人被诊断为胰腺外分泌肿瘤的发病率，并对 2000 至 2013 年间被诊断的患者五年后的年龄标准化净生存率进行了评估。我们还调查了 2010 至 2013 年间被诊断的患者的区域切除率和生存率的变化。数据从国家癌症登记和分析服务中提取。
1995 至 1999 年，外分泌胰腺肿瘤的年龄标准化年发病率为 17.1/100000，而 2010 至 2014 年则上升至 18.7/100000。2000 至 2009 年，年龄标准化一年和五年的净生存率分别为 17.9%和 3.6%，而 2010 至 2013 年则分别上升至 21.6%和 4.2%。在 2010 至 2013 年间，被诊断患有外分泌肿瘤的 23415 名患者中，有 2086 名（8.9%）进行了手术。在这些中心之间，该比例从 5.1%到 19.6%不等。在接受手术的患者中，一年生存率为 73.0%，五年生存率为 20.2%。在总共 2118 名接受手术的患者中，18 名（0.9%）处于 1 期；34 名（1.6%）处于 2 期；791 名（37.3%）处于 3 期；140 名（6.6%）处于 4 期，但有 53.6%的分期信息缺失。未进行手术的患者五年生存率为 2.1%。每个中心进行的手术数量与一年生存率无关。
尽管英格兰通过设立专科中心改善了胰腺癌的治疗，但切除率仍相对较低，生存率仍低于其他富裕国家。
