% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Huang:136916, author = {L. Huang$^*$ and L. Jansen$^*$ and Y. Balavarca$^*$ and M. Babaei$^*$ and L. van der Geest and V. Lemmens and L. Van Eycken and H. De Schutter and T. B. Johannesen and M. Primic-Žakelj and V. Zadnik and M. G. Besselink and P. Schrotz-King$^*$ and H. Brenner$^*$}, title = {{S}tratified survival of resected and overall pancreatic cancer patients in {E}urope and the {USA} in the early twenty-first century: a large, international population-based study.}, journal = {BMC medicine}, volume = {16}, number = {1}, issn = {1741-7015}, address = {London}, publisher = {BioMed Central}, reportid = {DKFZ-2018-01354}, pages = {125}, year = {2018}, abstract = {The prognosis of pancreatic cancer (PaC) strongly varies across different stages and age groups, which has unfortunately not been well recorded in the literature. This international population-based study aimed to provide tumor-node-metastasis (TNM) stage- and age-specific survival estimates and trends in resected and overall (resected and unresected) PaC in the early twenty-first century.Using data from the US Surveillance, Epidemiology, and End Results-18 Program and the national cancer registries of the Netherlands, Belgium, Norway, and Slovenia, short-term and long-term overall survival results stratified by TNM stage and age in resected and overall primary PaC, irrespective of being microscopically confirmed or not, in 2003-2014 were computed using the Kaplan-Meier method. The temporal survival trends over three predefined periods (2003-2005, 2006-2008, and 2009-2011) were further examined using the log-rank test.In total, data for 125,183 patients were analyzed. Overall, age-stratified 3-year survival was $20-34\%$ (< 60 years), $14-25\%$ (60-69 years), and $9-13\%$ (≥ 70 years) in stages I-II PaC; and $2-5\%$ (< 60 years), $1-2\%$ (60-69 years), and $< 1-1\%$ (≥ 70 years) in stages III-IV cancer. Patients who underwent operation had higher 3-year survival in each stage and age group (stages I-II: $23-39\%$ (< 60 years), $16-31\%$ (60-69 years), and $17-30\%$ (≥ 70 years); stages III-IV: $5-19\%$ (< 70 years) and $2-14\%$ (≥ 70 years)). Perioperative survival also decreased with advancing stage and older age (stages I-II: $98-100\%$ (< 60 years), $97-99\%$ (60-69 years), and $94-99\%$ (≥ 70 years); stages III-IV: $94-99\%$ (< 70 years) and $81-96\%$ (≥ 70 years)). Between 2003 and 2005 and 2009-2011, for overall PaC, both short-term and long-term survival improvements were observed in all countries except Belgium; for resected disease, short-term improvements were present only in the USA and Slovenia, but long-term improvements were observed in all countries except Slovenia, with stage-specific variations.Our large international study provides TNM stage- and age-specific population-based survival in overall and resected PaC that will facilitate clinical counseling. While the survival expectations for patients with resected PaC are substantially higher than the widely available and known dismal survival predictions for overall patients, conclusions on the benefits of resection cannot be made from this observational study. Patients with advanced-stage disease and/or older age should undergo careful risk assessment before treatment. Limited but inspiring improvement in survival is observed.}, cin = {C070 / G110 / L101}, ddc = {610}, cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 / I:(DE-He78)L101-20160331}, pnm = {313 - Cancer risk factors and prevention (POF3-313)}, pid = {G:(DE-HGF)POF3-313}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:30126408}, pmc = {pmc:PMC6102804}, doi = {10.1186/s12916-018-1120-9}, url = {https://inrepo02.dkfz.de/record/136916}, }