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@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},
}