Pancreas cancer — duct cell adenocarcinoma: Survival in relation to site, size, stage and type of therapy

The records of 508 patients with cancer of the pancreas admitted to Memorial Hospital in New York from 1949 through 1972 were examined. Ten distinctive morphological types were delineated and the pathological features and response to various modes of therapy of the most common type — duct adenocarcinoma — were studied in 380 patients. Median survival was related to: the site of the cancer — it was longer with tumors of the head than those of the body or tail; the size of the tumor — cancers smaller than 3 cm were associated with over twice the survival of those with large tumors; the stage — stage I patients had over twice the survival of those of stages II and III; and the type of therapy employed. Actuarial survival rate at one year was: with no specific therapy, 0%; with chemotherapy, 1%; after palliative by-pass surgery, 3%; following radiation therapy, 9%; and after all types of “curative” surgery, 21%. The only survivors at five years were in the “curative” surgery group, but these represented only 1% of all patients. Revolutionary changes in diagnosis and therapy will have to occur if significant increase in survival rate is to be achieved.