Five-Year Post-Op Survival Key Landmark for Pancreatic Cancer

January 10, 2007

BALTIMORE -- Patients who live at least five years after a pancreaticoduodenectomy for periampullary adenocarcinoma have a better than 50-50 chance of living another five years, according to a study here.

BALTIMORE, Jan. 10 -- Patients who live at least five years after a pancreaticoduodenectomy for periampullary adenocarcinoma have a better than 50-50 chance of living another five years, according to a study here.

In fact, 65% of five-year survivors went on to live at least 10 years or more, a Johns Hopkins team headed by Taylor S. Riall, M.D., reported in Surgery. Dr, Riall is now at the University of Texas Medical Branch in Galveston.

For comparison, the five-year survival rate of age-matched controls from the general U.S. population was 87%, Dr. Riall and colleagues pointed out.

However, less than one-quarter of patients who underwent surgery reached that initial five-year landmark, the study found. The term periampullary adenocarcinoma includes adenocarcinomas of the pancreas, ampulla of Vater, distal bile duct, and peri-Vaterian duodenum.

"While many studies have evaluated five-year survival and surgical resection for periampullary adenocarcinoma, few studies have reported survival past five years or the long-term prognosis for patients surviving to the five-year landmark," the authors said.

The current retrospective study examined data on 890 patients who underwent surgery at Hopkins from 1970 to 1999. However, the majority of procedures (755) were conducted in the 1990s. The data were analyzed in 2004.

About half the patients were male, and nearly all (92%) were white. Average age at time of surgery was 65.

Sixty-four percent had been diagnosed with pancreatic cancer, 16% distal bile duct cancer, 15% ampullary cancer, and 5% duodenal cancer.

A total of 201 patients (23%) survived five years after surgery. These survivors tended to be younger (average age 63.5; P=.02) and to have small tumors (2.6 cm versus 3 cm; P