AP-HP, Hépato-Gastroenterology et Digestive Oncology department, Pitié-Salpêtrière University Hospital, Sorbonne University, 47-83 Boulevard de l'Hôpital, Paris 75013, France.
AESIO SANTE Department Clinical Research team, Beau Soleil clinic, Montpellier 34070, France.
Clin Res Hepatol Gastroenterol. 2024 Oct;48(8):102426. doi: 10.1016/j.clinre.2024.102426. Epub 2024 Jul 21.
BACKGROUND & AIMS: Significant progress has been made in the management of pancreatic ductal adenocarcinoma (PDAC) in recent years. In this population-based study, we aimed to compare incidence, therapeutic strategies, and survival outcomes of PDAC patients in France over a decade.
This study was performed using a nationwide French database. All patients receiving care for PDAC during years 2009, 2014 and 2018 were included. Treatment modalities and survival outcomes were analyzed.
A total of 8143/8771/10494 patients were considered in 2009/2014/2018, respectively. Incidence increased mainly among patients aged >60 years. In localized PDAC, the proportion of patients receiving best supportive care (BSC) only decreased at 43.6/36.4/32.4 % and 27.8/29.1/34.3 % received chemo(radio)therapy alone. The rate of upfront surgery remained stable while 3/8/18 % of operated patients received neoadjuvant therapy. Median overall survival (OS) was 7.0/7.9/8.5 months in the overall population. Among treated patients, 1-year OS was 61.4/67.7/68.8 % and 30.3/36.3/38.8 % for localized and metastatic PDAC, respectively.
This study confirms the rising incidence of PDAC. Improved outcomes were seen in localized PDAC, with a wider use of chemotherapy and neoadjuvant strategies, and in treated metastatic patients. A modest survival gain was seen overall, hindered by the still high rate of patients receiving BSC only.
近年来，胰腺导管腺癌（PDAC）的治疗取得了显著进展。在这项基于人群的研究中，我们旨在比较法国十年来 PDAC 患者的发病率、治疗策略和生存结果。
本研究使用了一个全国性的法国数据库。纳入了 2009 年、2014 年和 2018 年期间接受 PDAC 治疗的所有患者。分析了治疗方式和生存结果。
分别有 8143/8771/10494 例患者于 2009/2014/2018 年纳入研究。发病率主要在 >60 岁患者中增加。在局限性 PDAC 中，仅接受最佳支持治疗（BSC）的患者比例分别下降至 43.6/36.4/32.4%和 27.8/29.1/34.3%，单独接受化疗（放疗）的患者比例分别下降至 27.8/29.1/34.3%。手术率保持稳定，而接受新辅助治疗的手术患者比例分别上升至 3/8/18%。总体人群的中位总生存期（OS）为 7.0/7.9/8.5 个月。在治疗患者中，1 年 OS 分别为局限性和转移性 PDAC 的 61.4/67.7/68.8%和 30.3/36.3/38.8%。
本研究证实了 PDAC 的发病率不断上升。局限性 PDAC 的治疗效果有所改善，化疗和新辅助策略的应用更加广泛，转移性患者的治疗效果也有所改善。总体而言，生存获益有限，这主要是由于仍有大量患者仅接受 BSC 治疗。
