Resection of pancreatic cancer in Europe and USA: An international large-scale study highlighting large variations

Journal article

Publication Details

Author(s): Huang L, Jansen L, Balavarca Y, Molina-Montes E, Babaei M, Van Der Geest L, Lemmens V, Van Eycken L, De Schutter H, Johannesen TB, Fristrup CW, Mortensen MB, Primic-Zakelj M, Zadnik V, Becker N, Hackert T, Magi M, Cassetti T, Sassatelli R, Grützmann R, Merkel S, Goncalves AF, Bento MJ, Hegyi P, Lakatos G, Szentesi A, Moreau M, Van De Velde T, Broeks A, Sant M, Minicozzi P, Mazzaferro V, Real FX, Carrato A, Molero X, Besselink MG, Malats N, Buechler MW, Schrotz-King P, Brennert H
Journal: Gut
Publication year: 2019
Volume: 68
Journal issue: 1
Pages range: 130-139
ISSN: 0017-5749


Objective: Resection can potentially cure resectable pancreatic cancer (PaC) and significantly prolong survival in some patients. This large-scale international study aimed to investigate variations in resection for PaC in Europe and USA and determinants for its utilisation. Design: Data from six European population-based cancer registries and the US Surveillance, Epidemiology, and End Results Program database during 2003-2016 were analysed. Age-standardised resection rates for overall and stage I-II PaCs were computed. Associations between resection and demographic and clinical parameters were assessed using multivariable logistic regression models. Results: A total of 153 698 records were analysed. In population-based registries in 2012-2014, resection rates ranged from 13.2% (Estonia) to 21.2% (Slovenia) overall and from 34.8% (Norway) to 68.7% (Denmark) for stage I-II tumours, with great international variations. During 2003-2014, resection rates only increased in USA, the Netherlands and Denmark. Resection was significantly less frequently performed with more advanced tumour stage (ORs for stage III and IV versus stage I-II tumours: 0.05-0.18 and 0.01-0.06 across countries) and increasing age (ORs for patients 70-79 and ≥80 versus those <60 years: 0.37-0.63 and 0.03-0.16 across countries). Patients with advanced-stage tumours (stage III-IV: 63.8%-81.2%) and at older ages (≥70 years: 52.6%-59.5%) receiving less frequently resection comprised the majority of diagnosed cases. Patient performance status, tumour location and size were also associated with resection application. Conclusion: Rates of PaC resection remain low in Europe and USA with great international variations. Further studies are warranted to explore reasons for these variations.

FAU Authors / FAU Editors

Grützmann, Robert Prof. Dr.
Lehrstuhl für Allgemein- und Viszeralchirurgie
Merkel, Susanne Prof. Dr.
Medizinische Fakultät

External institutions with authors

Academic Medical Centre / Academisch Medisch Centrum (AMC)
Autonomous University of Barcelona (UAB) / Universitat Autònoma de Barcelona
Belgian Cancer Registry (BCR) / Stichting Kankerregister
Centro de Investigación Biomédica en Red (CIBER)
Dansk Pancreas Cancer Database
Deutsches Krebsforschungszentrum (DKFZ)
Institute for Oncology Ljubljana (OIL)
Institut Jules Bordet
Instituto de Salud Carlos III (Institute of Health Carlos III, ISCIII)
Instituto Português de Oncologia Francisco Gentil (IPO) / Portuguese Oncology Institute
Istituto di ricovero e cura a carattere scientifico (IRCCS)
National Institute for Health Development (NIHD)
Netherlands Cancer Institute (NKI)
Netherlands Comprehensive Cancer Organisation / Integraal Kankercentrum Nederland (IKNL)
Odense Universitetshospital (OUH)
Sankt Istvan und Sankt Laszlo Krankenhaus und Poliklinik, Budapest
Universidad de Alcalá (UAH)
Università degli studi di Milano
Universitätsklinikum Heidelberg
University of Pécs

How to cite

Huang, L., Jansen, L., Balavarca, Y., Molina-Montes, E., Babaei, M., Van Der Geest, L.,... Brennert, H. (2019). Resection of pancreatic cancer in Europe and USA: An international large-scale study highlighting large variations. Gut, 68(1), 130-139.

Huang, Lei, et al. "Resection of pancreatic cancer in Europe and USA: An international large-scale study highlighting large variations." Gut 68.1 (2019): 130-139.


Last updated on 2019-03-06 at 12:53