Pancreatic cancer: management and survival

Aim: To review the management and survival from all pancreatic cancer over a 5‐year period at a tertiary referral hospital in New Zealand and to examine similar outcome data from the national cancer registry. Methods: A retrospective audit was conducted for the 5‐year period 1994−99 of patients discharged from Christchurch Hospital (Christchurch, New Zealand) and all patients in the New Zealand Cancer Registry with a diagnosis of pancreatic cancer. Kaplan− Meier survival curves were used for analysis. Results: From Christchurch Hospital a total of 230 patients were identified with a discharge diagnosis of pancreatic cancer. Medium survival for all groups was 3.9 months. There was a median survival of 1.6 months for the non‐interventional group, 3.1 months for the stent group, 6.2 months for the bypass group and 12.6 months for the pancreatico‐duodenectomy group. These data are very similar to the New Zealand National Cancer Registry data, where the overall median survival was 3.1 months and median survival for a pancreatico‐duodenectomy was 13.9 months. Conclusion: A pancreatico‐duodenectomy is usually a palliative surgical technique and not a curative procedure. Those selected for resection have been shown to have an advantage over operative bypass in terms of length of survival, however, this most likely reflects selection bias.