Cure probabilities of patients with pancreatic ductal adenocarcinoma in the United States: A Surveillance, Epidemiology, and End Results-based analysis.

Abstract

This study analyzed cure probabilities and the time required to achieve statistical cure in patients with pancreatic ductal adenocarcinoma in the United States. Patients diagnosed with pancreatic ductal adenocarcinoma between 2000 and 2021 were identified from the Surveillance, Epidemiology, and End Results database. Nonmixture cure models were utilized to compare the overall survival with the survival expected for a matched general population based on age and gender. A total of 125,706 patients were included; 25,724 (20.5%) underwent surgical resection. In the entire pancreatic ductal adenocarcinoma cohort, the overall cure fraction was 5.70% (95% confidence interval, 5.55%-5.89%). Cure probabilities decreased with older age and advancing clinical stage. However, there was no clinically meaningful difference in time to achieve statistical cure based on age or clinical stage. Patients who underwent surgical resection demonstrated higher probabilities of cure (25.24% vs 6.82%) and a shorter time to statistical cure (10.1 vs 12.3 years) than those who did not. Among patients with resected pancreatic ductal adenocarcinoma, cure probabilities decreased with older age, advancing clinical stage, and nodal positivity. Patients treated with neoadjuvant chemotherapy followed by surgery showed higher cure probabilities than those treated with upfront surgery (30.0% vs 17.05%). This study suggests that patients undergoing resection for pancreatic ductal adenocarcinoma may achieve a statistical cure. Earlier clinical stage, neoadjuvant chemotherapy, and negative nodal status seem to be associated with improved cure probabilities. These findings highlight the importance of early detection and multimodal treatment approaches to improve long-term outcomes in pancreatic ductal adenocarcinoma.