Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea.
Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2022 Jan;54(1):208-217. doi: 10.4143/crt.2021.421. Epub 2021 May 21.
Hospital-based clinical studies have limitations in holistic assessment of cancer treatment and prognosis, as they omit out-of-hospital patients including elderly individuals. This study aimed to investigate trends in initial treatment and corresponding prognosis of patients with exocrine pancreatic cancer (EPC) in Korea.
The Korea Central Cancer Registry data of patients with EPC from 2006 to 2017 were retrospectively reviewed. We defined the first course of treatment (FT) as the cancer-directed treatment administered within four months after cancer diagnosis according to the Surveillance, Epidemiology, and End Results (SEER) program.
Among 62,209 patients with EPC, localized and regional (LR) SEER stage; patients over 70 years old; and ductal adenocarcinoma excluding cystic or mucinous (DAC) accounted for 40.6%, 50.1%, and 95.9%, respectively. "No active treatment" (NT, 46.5%) was the most frequent, followed by non-surgical FT (28.7%) and surgical FT (22.0%). Among 25,198 patients with LR EPC, surgical FT increased (35.9% to 46.3%) and NT decreased (45.0% to 29.5%) from 2006 to 2017. The rate of surgical FT was inversely related to age (55.1% [< 70 years], 37.3% [70-79 years], 10.9% [≥ 80 years]). Five-year relative survival rates of LR DAC were higher after surgical FT than after NT in localized (46.1% vs. 12.9%) and regional stage (23.6% vs. 4.9%) from 2012 to 2017.
Less than half of overall patients with LR EPC underwent surgical FT, and this proportion decreased significantly in elderly individuals. Clinicians should focus attention on elderly patients with EPC to provide appropriate medical advice.
基于医院的临床研究在整体评估癌症治疗和预后方面存在局限性，因为它们忽略了包括老年人在内的院外患者。本研究旨在调查韩国外分泌胰腺肿瘤（EPC）患者初始治疗及相应预后的趋势。
回顾性分析 2006 年至 2017 年韩国中央癌症登记处 EPC 患者的数据。我们根据监测、流行病学和最终结果（SEER）计划将首次治疗（FT）定义为癌症诊断后四个月内给予的癌症定向治疗。
在 62209 例 EPC 患者中，局部和区域（LR）SEER 分期；70 岁以上患者；导管腺癌（不包括囊性或黏液性）分别占 40.6%、50.1%和 95.9%。最常见的是“无积极治疗”（NT，46.5%），其次是非手术 FT（28.7%）和手术 FT（22.0%）。在 25198 例 LR EPC 患者中，手术 FT 增加（35.9%至 46.3%），NT 减少（45.0%至 29.5%）。手术 FT 的比例与年龄呈反比（55.1%[＜70 岁]、37.3%[70-79 岁]、10.9%[≥80 岁]）。2012 年至 2017 年，LR DAC 局部（46.1%比 12.9%）和区域（23.6%比 4.9%）手术后的 5 年相对生存率均高于 NT。
不到一半的 LR EPC 患者接受了手术 FT，而且在老年患者中这一比例显著下降。临床医生应关注老年 EPC 患者，为其提供适当的医疗建议。
