Postresection survival outcomes of pancreatic cancer according to demographic factors and socio-economic status

Kuhn, Y.; Koscielny, A.; Glowka, T.; Hirner, A.; Kalff, J.C.; Standop, J.

doi:10.1016/j.ejso.2009.08.006

« Previous Next »European Journal of Surgical Oncology
Volume 36, Issue 5 , Pages 496-500, May 2010

Postresection survival outcomes of pancreatic cancer according to demographic factors and socio-economic status

Department of Surgery, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany

Accepted 17 August 2009.

Abstract

Aim

Aim of the study was to evaluate the impact of demographic factors (DGF) and socio-economic status (SES) on survival after pancreatic cancer resection in a German setting.

Methods

Patients with pancreatic adenocarcinoma and pancreaticoduodenectomy were identified from our pancreatic resection database (1989–2008). DGF, SES, survival and tumor-related information were obtained from hospital records, a registry office questionnaire, and telephone interviews with patients, relatives and general practitioners.

Results

Follow-up was completed in 117 patients. Median overall survival and 5-year survival rate was 22 month and 10%, respectively. Survival significantly improved over time with a 16% 5-year survival and a median survival of 27 month for recent patients. The longest survival period with a median of 63 month was observed for patients with AJCC stage I. Tumor-related factors and treatment period, but not SES influenced survival after pancreatic cancer resection in our cohort.

Conclusions

To our knowledge, this is the first study to explore survival from pancreatic cancer according to DGF and SES in a German setting. Disparities in survival among our patients depend solely on tumor-related factors and treatment period and could not be explained by SES including key factors like income or type of health insurance. The comparable postresection outcome of patients with low and high SES at our department could be in part due to the universal German multi-payer health system, based on compulsory enrolment for the majority, which seems not to support health care inequalities seen in other OECD countries.

Keywords: Pancreatic cancer, Resection, Survival, Demographic factors, Socio-economic status, Income level, Health insurance status

Abbreviations: AJCC, American Joint Committee on Cancer, ISCED, International Standard Classification of Education, DGF, Demographic factors, SES, Socio-economic status