BACKGROUND In recent years, new treatment options have become available for pancreatic ductal adenocarcinoma (PDAC) including 5-fluorouracil, leucovorin, irinotecan and oxaliplatin. The impact hereof has not been assessed in nationwide cohort studies. This population-based study aimed to investigate nationwide trends in incidence, treatment and survival of PDAC. MATERIALS AND METHODS Patients with PDAC (1997-2016) were included from the Netherlands Cancer Registry. Results were categorised by treatment and by period of diagnosis (1997-2000, 2001-2004, 2005-2008, 2009-2012 and 2013-2016). Kaplan-Meier survival analysis was used to calculate overall survival. RESULTS In a national cohort of 36,453 patients with PDAC, the incidence increased from 12.1 (1997-2000) to 15.3 (2013-2016) per 100,000 (p < 0.001), whereas median overall survival increased from 3.1 to 3.8 months (p < 0.001). Over time, the resection rate doubled (8.3%-16.6%, p-trend<0.001), more patients received adjuvant chemotherapy (3.0%-56.2%, p-trend<0.001) and 3-year overall survival following resection increased (16.9%-25.4%, p < 0.001). Over time, the proportion of patients with metastatic disease who received palliative chemotherapy increased from 5.3% to 16.1% (p-trend<0.001), whereas 1-year survival improved from 13.3% to 21.2% (p < 0.001). The proportion of patients who only received supportive care decreased from 84% to 61% (p-trend<0.001). CONCLUSION The incidence of PDAC increased in the past two decades. Resection rates and use of adjuvant or palliative chemotherapy increased with improved survival in these patients. In all patients with PDAC, however, the survival benefit of 3 weeks is negligible because the majority of patients only received supportive care.

中文翻译：

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胰腺导管腺癌的发病率，治疗和生存的全国趋势。

背景技术近年来，包括5-氟尿嘧啶，亚叶酸钙，伊立替康和奥沙利铂的胰腺导管腺癌（PDAC）已经有了新的治疗选择。在全国范围的队列研究中尚未评估其影响。这项基于人群的研究旨在调查全国PDAC发病率，治疗和生存趋势。材料与方法PDAC患者（1997-2016年）来自荷兰癌症登记处。结果按治疗和诊断期分类（1997-2000年，2001-2004年，2005-2008年，2009-2012年和2013-2016年）。Kaplan-Meier生存分析用于计算总体生存。结果在全国36,453例PDAC患者中，发病率从每100,000例12.1（1997-2000）上升到15.3（2013-2016）（p <0.001），而中位总生存期从3.1个月增加到3.8个月（p <0.001）。随着时间的流逝，切除率翻了一番（8.3％-16.6％，p-趋势<0.001），更多的患者接受了辅助化疗（3.0％-56.2％，p-趋势<0.001），并且切除后的3年总生存期增加了（16.9） ％-25.4％，p <0.001）。随着时间的流逝，接受姑息化疗的转移性疾病患者比例从5.3％增加到16.1％（p-趋势<0.001），而一年生存率从13.3％提高到21.2％（p <0.001）。仅接受支持治疗的患者比例从84％降至61％（p-trend <0.001）。结论在过去的20年中，PDAC的发病率有所增加。这些患者的切除率和辅助或姑息化学疗法的使用随着生存率的提高而增加。但是，在所有PDAC患者中，