Survival outcomes in pancreatic cancer: A single-center retrospective study in a large healthcare system.

Abstract

e16395 Background: Pancreatic cancer remains a highly lethal malignancy with limited improvements in survival. This study aimed to develop a pancreatic cancer registry within the Northwell Health System, analyzing patient survival outcomes based on biological and demographic factors. Methods: This retrospective study included patients diagnosed or treated with pancreatic cancer at Northwell Health (23 hospitals and 10 outpatient cancer centers across the NY metropolitan area) from 2008-2024. Patients diagnosed or treated outside Northwell were excluded. Kaplan-Meier survival curves were generated using Prism GraphPad, and log-rank tests were used to assess statistical significance. Results: A total of 7,112 patients were identified. Of these, 2,993 presented with metastatic disease, and 3,376 had localized disease. Surgical resection (n = 1,261) was associated with significantly longer median survival (49 vs. 9 months without resection; P < 0.001). Median survival for stages I, II, III, and IV were 30, 17, 14, and 5 months, respectively (P < 0.001). Median survival varied by race: White (11 months), Black (12 months), Hispanic (15 months), and Other (16 months) (P < 0.001). Median survival was 12 months for females (n = 3,672) and males (n = 3,432) (P = 0.466). Patients born in the US (n = 2,426) had a median survival of 11 months compared to 12 months for those born outside the US (n = 1,073) (P = 0.013). Survival improved among allcomers diagnosed over time, from 2008-2014 (9 mo; n = 2139), 2015-2019 (13 mo; n = 2334), and 2020-2024 (18 mo, n = 2244). Treatment at academic (n = 5,063) versus community (n = 1,888) cancer centers resulted in median survivals of 13 and 10 months, respectively (P < 0.001). Multivariable regression analysis showed the following β coefficients: racial minority (-0.20), non-adenocarcinoma histology (16.12), non-metastatic disease (11.67), and female sex (-0.67). All P < 0.001 except sex. Conclusions: Hispanic ethnicity, non-US birthplace, non-metastatic disease presentation, surgical resection, and treatment at an academic center were associated with improved survival outcomes. This study also suggests improvements in survival over time, potentially reflecting advancements in technology and treatment, but also highlights a disparity in care between academic and community cancer centers, which warrants further investigations.