Abstract
INTRODUCTION: With a rising incidence and unchanged poor prognosis, pancreatic cancer is increasingly becoming a focus of gastroenterological oncology, but there is a lack of real-world data. The aim of the current study was to investigate trends in survival and treatment patterns by analyzing German health claims data. METHODS: Pancreatic cancer patients diagnosed between 2010 and 2017 were identified from the German Pharmacoepidemiological Research Database (GePaRD, approximately 20% of the German population). Data on demographics, tumor treatment within 1 year after diagnosis, and survival were extracted. RESULTS: The study population comprised 23,339 patients with a median age of 74 years (IQR 66-80) and 44% with localized and 56% with metastatic disease. Overall, 52.4% received any chemotherapy, and curative intended resection was performed in 28.3%. Neoadjuvant and adjuvant therapy were performed in 4.4% and 58.7% of the cases, respectively. The median overall survival of the whole study population was 7.84 months. Patients diagnosed in the most recent period (2014-2017) had a significantly better prognosis (8.20 months (95% CI 7.97-8.43)) than patients who were diagnosed in the earlier period (2010-2013) (7.54 months (95% CI 7.31-7.70), p < 0.001), with an age-, sex-, and stage-adjusted hazard ratio of 0.87 (95% CI 0.85-0.9). Over time, the most pronounced treatment trends have affected patients with localized disease, with increasing frequency of resection and neoadjuvant therapy and decreasing frequency of best supportive care. CONCLUSION: This comprehensive insight into survival and treatment of pancreatic cancer in Germany shows presumably medically beneficial therapy trends with, however, only marginal improvements in prognosis to date.