Carpelan-Holmström M et al. (2005) Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry. Gut 54: 385–387

Although prognosis is generally very poor in patients with pancreatic ductal adenocarcinoma, long-term survival rates are unclear. A team from Finland has recently studied their nationwide cancer registry data in an attempt to clarify this question.

The registry collects data on cancer cases throughout the Finnish population of 5.1 million people. In the period 1990–1996, 4,922 cases of pancreatic cancer were recorded. Of these, 89 patients survived for at least 5 years; these cases were re-evaluated by the investigators.

Almost half of the long-term survivors had tumors other than pancreatic ductal adenocarcinoma. Of the remaining 44 patients, histologic confirmation of pancreatic cancer was lacking in 18 cases. There were only 26 cases, therefore, of histologically proven pancreatic ductal adenocarcinoma. Re-evaluation of the corresponding slides or paraffin blocks by Carpelan-Holmström and colleagues, however, confirmed the diagnosis in only 10 cases. With the exception of two cases where histologic specimens were unavailable, the remainder were considered by the investigators to have been wrongly diagnosed.

Given that 90% of pancreatic cancers are pancreatic ductal adenocarcinoma, say the authors, the true 5-year survival rate for patients with this tumor was only 0.2%. They conclude that higher long-term survival rates probably stem from false diagnoses, and encourage thorough histopathologic review of all patients with pancreatic cancer.