Cumulative morbidity and late mortality in long-term survivors of exocrine pancreas cancer

Background: Less than 5% of patients diagnosed with exocrine pancreas cancer live to be long-term survivors (5+ years after diagnosis). As a result, few studies have focused on these patients' cumulative, cancer-related morbidity and late mortality. This descriptive study was undertaken to explore such issues. Methods: One thousand eight hundred thirty consecutive patients who had exocrine pancreas cancer had been seen at the Mayo Clinic between 1995 and 2001 and who had well-documented evidence of having lived for 5+ years were the focus of this study. Results: Only 85 patients (4.6%) met all the above criteria. These patients had a median age of 65 years with a slight female predominance (53%). Eighty-one (95%) were treated with surgery, 42 (49%) with chemotherapy, and 41 (48%) with radiation. Cumulative morbidity included one or more subsequent surgeries in 17 patients (20%), one or more major infections in 14 (16%), diabetes in 39 (45%), depression in 16 (19%), and a second malignancy in 17 (20%). Twenty-nine patients were deceased at the time of this report; 15 (18%) died from recurrent pancreas cancer more than 5 years after their original diagnosis. Conclusion: Long-term survivors of exocrine pancreas cancer confront notable rates of cumulative morbidity, which include subsequent major surgeries, major infections, diabetes, depression, and second malignancies, as well as late deaths from pancreas cancer itself. © 2009 Humana Press Inc.