Trends in survival, mortality determinants, and demographic factors in pancreatic carcinoma: An analysis from 2000 to 2021.

Abstract

e16434 Background: Pancreatic carcinoma is among the deadliest malignancies, with persistently low survival rates and significant disparities in outcomes across demographic groups. Understanding trends in survival, mortality determinants, and demographic factors is critical for improving prognosis and guiding targeted interventions. Methods: We analyzed pancreatic carcinoma cases from the SEER database (2000–2021) using SEER*Stat version 8.4.4. We included only microscopically confirmed malignant cases with histology codes 8012/3 (Large cell carcinoma, NOS), 8013/3 (Large cell neuroendocrine carcinoma), and 8010/3 (Carcinoma, NOS) from ICD-O-3. Key demographic and clinical data (age, sex, race, tumor histology, treatment modalities) were extracted. Survival outcomes were assessed via Kaplan-Meier curves, while multivariable Cox regression evaluated mortality predictors and hazard ratios (HRs) with 95% confidence intervals (CIs). Survival trends were analyzed across age groups and racial/ethnic groups, stratified by sex and tumor characteristics. Statistical analysis was conducted using R statistical packages, with significance set at p < 0.05 Results: Analysis of SEER data (2000–2021) revealed significant disparities in survival and mortality determinants among pancreatic carcinoma patients. Median survival varied markedly by age: 111 months (95% CI: 96–126) for young patients, 9 months (95% CI: 9–9) for middle-aged, and 3 months (95% CI: 3–3) for older adults. The 5-year survival rates were 54.8% (young), 26.5% (middle-aged), and 10.7% (older). Multivariable Cox regression confirmed age as a critical determinant, with young patients having 72% lower mortality risk than older adults (HR = 0.28, p < 0.001). Treatment modalities significantly impacted outcomes: chemotherapy (HR = 0.63, p < 0.001) and radiation (HR = 0.68, p < 0.001) reduced mortality risk, with 5-year survival rates of 21.3% (chemotherapy recipients) and 22.2% (radiation recipients), compared to 15.5% for non-recipients, respectively. Demographic disparities persisted: Hispanic patients exhibited better survival (5-year: 24.9%) than Black (17.4%) and White (15.9%) patients, with Black individuals facing a 7% higher risk than White (HR = 1.07, p < 0.001). Males had marginally worse survival than females (5-year: 15.8% vs. 17.8%; HR = 1.05, p < 0.001). Tumor location further stratified outcomes, with neuroendocrine carcinoma associated with longer median survival (10 vs. 6 months for large cell carcinoma). Conclusions: we concluded that younger patients survive better than older adults. Chemotherapy/radiation improve outcomes. Hispanic patients fare better than Black/White peers, with higher Black mortality. Males show worse survival than females; neuroendocrine tumors link to longer survival. Findings highlight needs for equitable care, tailored treatments, and early detection.