Ten weeks to live: A population-based study on treatment and survival of patients with metastatic pancreatic cancer in the south of the Netherlands

Figures & data

Table I. Characteristics of patients with metastatic pancreatic cancer, by period of diagnosis (N = 1494).

	Total		1993–1996		1997–2000		2001–2004		2005–2008		2009–2010
	N	(%)	N	(%)	N	(%)	N	(%)	N	(%)	N	(%)	p–Value
Sex
Male	829	(55.5)	119	(63.3)	135	(49.6)	171	(55.7)	250	(56.9)	154	(53.5)	0.46
Female	665	(44.5)	69	(36.7)	137	(50.4)	136	(44.3)	189	(43.1)	134	(46.5)
Age (years)
< 50	93	(6.2)	22	(11.7)	15	(5.5)	20	(6.5)	26	(5.9)	10	(3.5)	0.03
50–59	241	(16.1)	36	(19.1)	54	(19.9)	50	(16.3)	67	(15.3)	34	(11.8)
60–69	512	(34.3)	57	(30.3)	92	(33.8)	110	(35.8)	151	(34.4)	102	(35.4)
70–79	469	(31.4)	53	(28.2)	87	(32.0)	91	(29.6)	140	(31.9)	98	(34.0)
≥ 80	179	(12.0)	20	(10.6)	24	(8.8)	36	(11.7)	55	(12.5)	44	(15.3)
Socioeconomic status (SES)
Low	372	(24.9)	42	(22.3)	85	(31.3)	75	(24.4)	102	(23.2)	68	(23.6)	< 0.01
Intermediate	584	(39.1)	59	(31.4)	99	(36.4)	118	(38.4)	187	(42.6)	121	(42.0)
High	424	(28.4)	57	(30.3)	70	(25.7)	97	(31.6)	127	(28.9)	73	(25.3)
Institutions	72	(4.8)	14	(7.5)	16	(5.9)	13	(4.2)	13	(3.0)	16	(5.6)
Unknown	42	(2.8)	16	(8.5)	2	(0.7)	4	(1.3)	10	(2.2)	10	(3.5)
No. of comorbid conditions
0	712	(47.7)	105	(55.9)	151	(55.5)	141	(45.9)	198	(45.1)	117	(40.6)	< 0.01
1	469	(31.4)	34	(18.1)	70	(25.7)	100	(32.6)	155	(35.3)	110	(38.2)
≥ 2	179	(12.0)	14	(7.4)	22	(8.1)	30	(9.8)	60	(13.7)	53	(18.4)
Unknown	134	(9.0)	35	(18.6)	29	(10.7)	36	(11.7)	26	(5.9)	8	(2.8)
Histologic subtype
Adenocarcinoma	1023	(68.5)	134	(71.3)	175	(64.3)	197	(64.2)	303	(69.0)	214	(74.3)	0.12
No histology	471	(31.5)	54	(28.7)	97	(35.7)	110	(35.8)	136	(31.0)	74	(25.7)
Metastatic site
Liver	840	(56.2)	114	(60.6)	165	(60.7)	192	(62.5)	232	(52.8)	137	(47.6)	< 0.01
Peritoneal	124	(8.3)	16	(8.5)	31	(11.4)	15	(4.9)	32	(7.3)	30	(10.4)
Lung	47	(3.1)	7	(3.7)	6	(2.2)	9	(2.9)	10	(2.3)	15	(5.2)
Lymph nodes	45	(3.0)	4	(2.1)	12	(4.4)	9	(2.9)	14	(3.2)	6	(2.1)
Other / unknown	78	(5.2)	22	(11.7)	15	(5.5)	17	(5.5)	18	(4.1)	6	(2.1)
2 organs	270	(18.1)	18	(9.6)	40	(14.7)	43	(14.0)	108	(24.6)	61	(21.2)
≥ 3 organs	90	(6.0)	7	(3.7)	3	(1.1)	22	(7.2)	25	(5.7)	33	(11.5)
Hospital of diagnosis
Hospital A	228	(15.3)	21	(11.2)	46	(16.9)	41	(13.4)	69	(15.7)	51	(17.7)	0.01
Hospital B	85	(5.7)	16	(8.5)	11	(4.0)	26	(8.5)	13	(3.0)	19	(6.6)
Hospital C	154	(10.3)	13	(6.9)	26	(9.6)	29	(9.4)	45	(10.3)	41	(14.2)
Hospital D	119	(8.0)	14	(7.4)	25	(9.2)	26	(8.5)	36	(8.2)	18	(6.3)
Hospital E	72	(4.8)	11	(5.9)	12	(4.4)	18	(5.9)	19	(4.3)	12	(4.2)
Hospital F	217	(14.5)	23	(12.2)	38	(14.0)	38	(12.4)	76	(17.3)	42	(14.6)
Hospital G	236	(15.8)	33	(17.6)	35	(12.9)	43	(14.0)	77	(17.5)	48	(16.7)
Hospital H	131	(8.8)	17	(9.0)	23	(8.5)	37	(12.1)	32	(7.3)	22	(7.6)
Hospital I	107	(7.2)	21	(11.2)	24	(8.8)	17	(5.5)	29	(6.6)	16	(5.6)
Hospital J	145	(9.7)	19	(10.1)	32	(11.8)	32	(10.4)	43	(9.8)	19	(6.6)
Chemotherapy
Yes	272	(18.2)	18	(9.6)	26	(9.6)	60	(19.5)	90	(20.5)	78	(27.1)	< 0.01
No	1222	(81.8)	170	(90.4)	246	(90.4)	247	(80.5)	349	(79.5)	210	(72.9)
Total	1494		188	(12.6)	272	(18.2)	307	(20.6)	439	(29.4)	288	(19.3)

Figure 1. Administration of chemotherapy for patients diagnosed with metastatic pancreatic cancer between 1993 and 2010 in the southern Netherlands according to period of diagnosis (N = 1494).

Table II. Crude percentages, unadjusted and adjusted odds for receiving chemotherapy among patients diagnosed with metastatic pancreatic cancer between 1993 and 2010 in the southern Netherlands^a (N = 1494).

	Crude percentage %	Univariate odds ratio (95% CI)	Multivariate odds ratio (95% CI)
Sex
Male	19.7	1.00 (reference)	1.00 (reference)
Female	16.4	0.80 (0.61–1.05)	0.91 (0.67–1.24)
Age (years)
< 50	37.6	2.21 (1.38–3.53)	2.43 (1.41–4.18)
50–59	29.0	1.50 (1.06–2.12)	1.68 (1.13–2.49)
60–69	21.5	1.00 (reference)	1.00 (reference)
70–79	11.7	0.49 (0.34–0.69)	0.49 (0.33–0.73)
≥ 80	1.1	0.04 (0.01–0.17)	0.04 (0.01–0.18)
Socioeconomic status (SES)
Low	13.4	1.00 (reference)	1.00 (reference)
Intermediate	17.8	1.40 (0.97–2.01)	1.18 (0.78–1.79)
High	25.9	2.26 (1.56–3.26)	2.05 (1.34–3.13)
Number of comorbid conditions
0	21.5	1.00 (reference)	1.00 (reference)
1	17.3	0.76 (0.57–1.03)	0.77 (0.54–1.09)
≥ 2	14.0	0.59 (0.38–0.94)	0.69 (0.41–1.16)
Histologic subtype
Adenocarcinoma	23.7	1.00 (reference)	1.00 (reference)
No histology	6.4	0.22 (0.15–0.33)	0.33 (0.21–0.51)
Site of metastases
Liver	18.6	1.00 (reference)	1.00 (reference)
Peritoneal	17.7	0.95 (0.58–1.55)	0.78 (0.45–1.37)
Lung	12.8	0.64 (0.27–1.54)	1.01 (0.38–2.68)
Extraregional nodes	15.6	0.81 (0.35–1.84)	0.81 (0.32–2.03)
Other	12.8	0.65 (0.33–1.28)	0.76 (0.35–1.63)
2 organs	18.9	1.02 (0.72–1.45)	0.81 (0.54–1.22)
3 + organs	22.2	1.25 (0.74–2.12)	0.80 (0.44–1.48)
Period of diagnosis
1993–1996	9.6	1.00 (reference)	1.00 (reference)
1997–2000	9.6	1.00 (0.53–1.88)	1.71 (0.85–3.46)
2001–2004	19.5	2.29 (1.31–4.02)	4.08 (2.15–7.73)
2005–2008	20.5	2.44 (1.42–4.17)	4.61 (2.48–8.58)
2009–2010	27.1	3.51 (2.02–6.09)	7.40 (3.87–14.15)
Hospital of diagnosis
Hospital A	14.9	1.00 (reference)	1.00 (reference)
Hospital B	29.4	2.38 (1.32–4.30)	4.08 (2.05–8.14)
Hospital C	18.2	1.27 (0.73–2.19)	1.36 (0.74–2.50)
Hospital D	5.0	0.30 (0.12–0.74)	0.39 (0.15–1.02)
Hospital E	13.9	0.92 (0.43–1.97)	1.07 (0.47–2.44)
Hospital F	11.1	0.71 (0.41–1.24)	0.87 (0.48–1.58)
Hospital G	34.3	2.98 (1.90–4.69)	5.27 (3.15–8.82)
Hospital H	15.3	1.03 (0.56–1.87)	1.22 (0.63–2.35)
Hospital I	22.4	1.65 (0.92–2.95)	1.86 (0.98–3.55)
Hospital J	13.8	0.91 (0.50–1.66)	1.04 (0.55–1.98)

^aAdjusted for all variables listed. Included in the analysis but results not shown, SES institutionalised, SES unknown and comorbidity unknown.

Figure 2. Overall survival of patients diagnosed with metastatic pancreatic cancer between 1993 and 2010 in the southern Netherlands according to period of diagnosis (N = 1494).

Table III. Crude median overall survival, crude 1-year survival, unadjusted and adjusted hazard ratios for patients diagnosed with metastatic pancreatic cancer between 1993 and 2010 in the southern Netherlands^a (N = 1494).

	Crude median survival (weeks)	Crude 1-year survival (%)	Univariate HR (95%)	Multivariable HR (95% CI)
Sex
Male	9.4	6.0	1.00 (Reference)	1.00 (Reference)
Female	9.9	5.4	0.97 (0.88–1.07)	0.89 (0.80–0.99)
Age (years)
< 50	14.3	8.6	0.85 (0.68–1.06)	1.02 (0.81–1.28)
50–59	12.0	7.1	0.92 (0.79–1.07)	1.00 (0.86–1.18)
60–69	11.1	7.6	1.00 (Reference)	1.00 (Reference)
70–79	7.9	3.2	1.36 (1.20–1.54)	1.20 (1.05–1.37)
≥ 80	5.1	3.4	1.75 (1.48–2.08)	1.38 (1.14–1.67)
Socioeconomic status (SES)
Low	8.7	3.8	1.00 (reference)	1.00 (Reference)
Intermediate	9.4	4.8	0.93 (0.82–1.06)	0.97 (0.85–1.11)
High	10.9	8.7	0.79 (0.68–0.91)	0.87 (0.75–1.00)
Number of comorbid conditions
0	10.0	6.6	1.00 (Reference)	1.00 (Reference)
1	9.0	4.7	1.15 (1.02–1.29)	1.03 (0.91–1.17)
≥ 2	9.0	2.8	1.27 (1.07–1.49)	1.05 (0.88–1.24)
Histologic subtype
Adenocarcinoma	10.4	6.5	1.00 (Reference)	1.00 (Reference)
No histology	7.6	4.0	1.26 (1.13–1.40)	1.02 (0.90–1.16)
Site of metastases
Liver	9.7	5.6	1.00 (Reference)	1.00 (Reference)
Peritoneal	8.2	5.7	1.06 (0.88–1.28)	1.05 (0.86–1.27)
Lung	17.9	6.4	0.69 (0.52–0.93)	0.56 (0.41–0.75)
Extra regional nodes	21.6	20.0	0.60 (0.44–0.81)	0.50 (0.37–0.69)
Other	10.6	6.4	0.89 (0.71–1.12)	0.84 (0.66–1.06)
2 organs	7.1	4.1	1.17 (1.02–1.35)	1.13 (0.99–1.31)
3 or more organs	5.6	3.3	1.46 (1.17–1.81)	1.65 (1.32–2.07)
Period of diagnosis
1993–1996	10.9	3.7	1.00 (reference)	1.00 (Reference)
1997–2000	8.7	5.9	1.16 (0.96–1.39)	1.25 (1.03–1.52)
2001–2004	9.7	7.2	1.03 (0.86–1.23)	1.19 (0.99–1.44)
2005–2008	9.7	5.0	1.05 (0.89–1.25)	1.21 (1.01–1.45)
2009–2010	9.0	6.3	1.05 (0.87–1.26)	1.32 (1.08–1.61)
Hospital of diagnosis
Hospital A	10.4	5.3	1.00 (Reference)	1.00 (Reference)
Hospital B	12.6	7.1	0.84 (0.66–1.08)	0.92 (0.71–1.20)
Hospital C	9.4	7.1	0.92 (0.75–1.12)	0.86 (0.70–1.07)
Hospital D	7.1	4.2	1.12 (0.90–1.40)	1.00 (0.79–1.25)
Hospital E	9.3	6.9	0.96 (0.74–1.26)	0.86 (0.65–1.12)
Hospital F	8.9	3.7	1.09 (0.91–1.32)	0.98 (0.81–1.19)
Hospital G	10.2	5.9	0.91 (0.76–1.10)	1.01 (0.84–1.23)
Hospital H	8.1	3.8	1.20 (0.96–1.48)	1.15 (0.92–1.43)
Hospital I	9.1	9.4	0.94 (0.75–1.19)	1.02 (0.80–1.30)
Hospital J	10.1	6.2	1.04 (0.85–1.28)	0.97 (0.78–1.20)
Chemotherapy
No	7.6	3.1	1.00 (reference)	1.00 (Reference)
Yes	25.3	17.3	0.41 (0.36–0.47)	0.39 (0.34–0.46)

^aAdjusted for all variables listed. Included in the analysis but results not shown, SES unknown, comorbidity unknown, and tumor differentiation grade unknown.