Pancreatic cancer: Current status of treatment and survival of 16071 patients diagnosed from 1981-1996, using the Japanese National Pancreatic Cancer Database

Background. The Japanese Pancreas Society Registry Committee obtained data on 16071 patients with pancreatic cancer diagnosed from 1981 to 1996. This is the largest multi-institutional retrospective study of the Japanese experience to describe the extent of disease and survival. Methods. Data were summarized according to age and sex and location of the disease. Survival analysis, using the Kaplan-Meier method, was performed according to surgical stage and therapeutic categories. Results. The male:female ratio was 1.6:1. The peak age was in the patients' sixties for both sexes. Forty-five percent of the primary tumors were located in the head of the pancreas. The survival of the patients depended on the histological diagnosis and surgical stage. The most common histology, invasive ductal carcinoma, had the worst prognosis, and the 5-year survival of patients with stage I, II, III, IVa, and IVb disease was 66%, 55%, 21%, 11%, and 6% respectively. At the time of presentation, only 2.5% of the patients had stage I disease, while more than 70% had stage IV. Conclusions. Improvements in early detection strategies and more effective chemical or biological therapeutic agents, together with pancreatectomy, tested in well organized randomized prospective trials, will be the only way to cure this fatal disease.