Evolution of the chemotherapeutic landscape and survival outcome in patients with metastatic pancreatic cancer: a four-institute cohort study in Taiwan, 2010–2016

Figures & data

Table 1 Baseline characteristics of pancreatic cancer patients (n=654)

Characteristics	Value (%)
Median age, year (range)	62 (25–88)
Sex
Male	393 (60.1)
Female	261 (39.9)
Body mass index, Kg/m^2 (range)	22.4 (13.0–36.2)
Smoking history	249 (38.1)
ECOG performance scale
0–1	450 (68.8)
2	174 (26.6)
3	30 (4.6)
Charlson comorbidity index
0	177 (27.1)
1	227 (34.7)
2	148 (22.6)
3	79 (12.1)
4	18 (2.8)
5	5 (0.8)
Tumor size, cm (range)	4.5 (1.4–14.0)
Primary tumor site
Head	224 (34.3)
Body	121 (18.5)
Tail	162 (24.8)
Overlapping	147 (22.5)
T-classification
1	13 (2)
2	82 (12.5)
3	188 (28.7)
4	371 (56.7)
N-classification
0	134 (20.5)
1	520 (79.5)
Site of metastases
Liver	438 (67.0)
Peritoneum	239 (36.5)
Distant lymph nodes	150 (22.9)
Lung	98 (15.0)
Others	51 (7.8)
Chemotherapy agent
Gemcitabine	620 (94.8)
Cisplatin	343 (52.4)
S-1	249 (38.1)
5-FU	194 (29.7)
Irinotecan	15 (2.3)
Erlotinib	12 (1.8)
Nab-paclitaxel	9 (1.4)
Others	72 (12.8)

Abbreviation: ECOG, Eastern Cooperative Oncology Group.

Figure 1 Survival outcome of patients with metastatic pancreatic cancer according to year of diagnosis.

Figure 2 Crude 6-, 12-, and 24-month survival rates of pancreatic cancer patients, 2010–2016.

Table 2 Joinpoint analysis of trend for pancreatic cancer survival rate, 2010–2016

Survival rate	Trend 1		Trend 2		Trend 3
	Years	Adjusted AAPCa (95% CI)	Years	Adjusted AAPCa (95% CI)	Years	Adjusted AAPCa (95% CI)
6 months	2010–2016	5.5% (1.2–9.9)*	2010–2013	2.6% (−11.9–19.5)	2013–2016	4.8% (−12.2–25.1)
12 months	2010–2016	13.6% (0.3–28.7)*	2010–2013	7.0% (−46.6–114.2)	2013–2016	27.6% (−12.8–86.9)
24 months	2010–2015	25.1% (6.1–42.3)*	2010–2013	12.5% (−44.4–127.8)	2013–2015	5.5% (−2.6–24.6)

Notes:

a Adjusted for sex, age, Charlson comorbidity, ECOG PS, site of metastatic organ, smoking history, and institute of treatment.

* P<0.05.

Abbreviations: AAPC, average annual percent change; ECOG PS, European Cooperative Oncology Group Performance Status.

Figure 3 Chemotherapy agents received according to year of diagnosis.

Note: The subtraction of each single agent with different colors, blue, orange, and gray, indicating each used in the first, second, or third and above line of treatment settings, respectively.

Table 3 Survival outcome of pancreatic cancer patients according to chemotherapy agents

Chemotherapy agents		N	Median survival time, months (95% CI)	HR (95% CI)	P-value	Adjusted HRa (95% CI)	P-value
Gemcitabine-treated	No	34	3.3 (1.8–4.8)	1		1
	Yes	620	6.7 (6.1–7.4)	0.40 (0.28–0.57)	<0.001	0.63 (0.43–0.91)	0.014
S-1-treated	No	405	5.2 (4.8–5.7)	1		1
	Yes	249	8.6 (7.6–9.6)	0.55 (0.46–0.65)	<0.001	0.56 (0.480.67)	<0.001
Cisplatin-treated	No	311	4.5 (4.0–5.1)	1		1
	Yes	343	8.2 (7.6–8.7)	0.50 (0.43–0.59)	<0.001	0.61 (0.51–0.73)	<0.001
5-FU-treated	No	460	5.5 (5.0–6.0)	1		1
	Yes	194	9.0 (7.6–10.5)	0.58 (0.49–0.69)	<0.001	0.65 (0.54–0.78)	<0.001
Other agents-treatedb	No	546	5.7 (5.1–6.3)	1		1
	Yes	108	10.3 (9.2–11.4)	0.58 (0.43–0.75)	<0.001	0.64 (0.51–0.80)	<0.001

Notes:

a Adjusted for sex, age, Charlson comorbidity, ECOG PS, site of metastatic organ, and smoking history.

b Other agents included chemotherapeutic agents with irinotecan, oxaliplatin, nab-paclitaxel, and erlotinib.

Abbreviation: ECOG PS, European Cooperative Oncology Group performance status.

Figure S1 Lines of chemotherapy treatment received by patients according to year of diagnosis.

Figure S2 Chemotherapy regimens that patients received as first-line treatment in 2010–2016.