With a mere 12.5% of patients surviving five years, the stark statistics of pancreatic cancer prognosis reveal a challenging journey, yet they also hold critical insights for patients and families navigating this complex disease.
Key Takeaways
- The 5-year overall survival rate for pancreatic cancer patients diagnosed between 2014 and 2020 is 12.5%
- Median overall survival for unresectable pancreatic ductal adenocarcinoma is 11.1 months
- 1-year survival rate for pancreatic cancer is 42%, based on SEER data 2013-2019
- The 5-year survival rate for localized pancreatic cancer is 44.3%
- Median survival for stage I pancreatic ductal adenocarcinoma is 32 months
- 5-year survival for regional stage pancreatic cancer is 15.9%
- CA19-9 level >1000 U/mL worsens prognosis with HR 2.5
- Elevated preoperative CRP predicts poorer survival with median 8 months
- KRAS mutation present in 90% correlates with median survival 12 months
- Gemcitabine plus nab-paclitaxel median OS 8.5 months vs 6.7 gem alone
- FOLFIRINOX median survival 11.1 months vs 6.8 gemcitabine in metastatic
- Whipple procedure 5-year survival 25% for resectable tumors
Pancreatic cancer survival rates remain very poor but are slowly improving.
Overall Survival
- The 5-year overall survival rate for pancreatic cancer patients diagnosed between 2014 and 2020 is 12.5%
- Median overall survival for unresectable pancreatic ductal adenocarcinoma is 11.1 months
- 1-year survival rate for pancreatic cancer is 42%, based on SEER data 2013-2019
- 3-year overall survival rate for pancreatic adenocarcinoma is 15.2%
- Overall survival at 2 years for metastatic pancreatic cancer is 9%
- The 5-year survival rate for pancreatic neuroendocrine tumors is 61% for localized disease but drops to 15% overall
- Median survival for all pancreatic cancer stages is 11 months per NCDB data 2004-2016
- 10-year overall survival rate for pancreatic cancer is 2.8%
- Overall survival rate at 6 months for advanced pancreatic cancer is 65%
- 5-year survival for pancreatic cancer in Europe averages 7-9%
- Median overall survival for pancreatic cancer patients over 80 years is 4.6 months
- 1-year overall survival improved from 25% in 2000 to 36% in 2020
- Overall 5-year survival for stage IV pancreatic cancer is 3.2%
- Median survival for locally advanced pancreatic cancer is 15 months
- 2-year survival rate for all pancreatic cancers is 20.1%
- Overall survival hazard ratio for pancreatic cancer vs other GI cancers is 2.3
- 5-year survival rate for pancreatic cancer in Asia is 8.5%
- Median overall survival post-diagnosis for pancreatic cancer is 6.7 months in population studies
- 30-day survival post-diagnosis is 85% for pancreatic cancer
- 5-year conditional survival improves to 25% if surviving 5 years initially
- Overall survival for pancreatic acinar cell carcinoma is 45% at 5 years
- Median survival for pancreatic cancer in the UK is 9 months
- 1-year survival for pancreatic cancer patients under 50 is 55%
- Overall 3-year survival rate is 12% per EUROCARE-5 data
- Median overall survival for gemcitabine-treated patients is 5.7 months
- 5-year survival rate has increased 1% per decade since 1975
- Overall survival for stage I-III pancreatic cancer is 28% at 1 year
- 2-year overall survival for resectable cases is 35%
- Median survival for palliative care pancreatic cancer patients is 3.5 months
- 5-year overall survival for cystic pancreatic neoplasms is 75%
Overall Survival Interpretation
While these grim numbers might tempt one to plan a farewell tour, the slight but stubborn rise in survival rates over the decades offers a much tougher and more important message: we are slowly, agonizingly, winning a war of inches against a ruthless enemy, so the fight for research and early detection must rage even harder.
Prognostic Factors
- CA19-9 level >1000 U/mL worsens prognosis with HR 2.5
- Elevated preoperative CRP predicts poorer survival with median 8 months
- KRAS mutation present in 90% correlates with median survival 12 months
- High tumor mutational burden (TMB) HR for death 1.8 in pancreatic cancer
- SMAD4 loss associated with 50% reduced 2-year survival
- Age >70 years increases mortality risk by 1.5-fold
- ECOG performance status >1 predicts median survival 4 months
- Diabetes mellitus at diagnosis HR 1.3 for overall survival
- Perineural invasion present in 80% worsens 5-year survival to 10%
- Lymphovascular invasion HR 2.1 for recurrence-free survival
- High NLR (>5) predicts median OS 7 months vs 14 months low NLR
- TP53 mutation correlates with aggressive disease and OS 9 months
- Positive resection margins R1/R2 reduce 5-year survival to 8%
- Obesity (BMI>30) HR 1.4 for pancreatic cancer mortality
- Low albumin <3.5 g/dL at diagnosis median survival 6 months
- CDKN2A alteration present in 70% shortens DFS to 10 months
- Smoking history increases recurrence risk HR 1.6
- High Ki-67 index (>20%) predicts poor OS HR 2.2
- BRCA2 mutation improves response but baseline HR 1.2
- Neutrophil-lymphocyte ratio >4 HR 1.9 for 1-year mortality
- Poorly differentiated grade 3 tumors 5-year survival 5%
- Elevated LDH > upper limit HR 2.0 for OS
- Family history of pancreatic cancer HR 1.7 for worse prognosis
- Microsatellite instability (MSI-H) rare but better prognosis OS 20 months
- Hypoalbuminemia and high CA19-9 combo HR 3.5
- R0 resection improves median survival by 12 months vs R1
- Pancreas resection with vascular involvement worsens OS to 15 months
Prognostic Factors Interpretation
While a cancer cell's success in the pancreas appears to rely on a daunting committee vote—where bad factors like high CA19-9, inflammation, and nerve invasion consistently outnumber the rare good ones like a clean resection—the overall prognosis reads like a grim report card where almost every metric, from genes to glucose, conspires to shorten the sentence.
Stage-Specific Prognosis
- The 5-year survival rate for localized pancreatic cancer is 44.3%
- Median survival for stage I pancreatic ductal adenocarcinoma is 32 months
- 5-year survival for regional stage pancreatic cancer is 15.9%
- Stage II pancreatic cancer 3-year survival is 28%
- Distant metastatic pancreatic cancer has 3.4% 5-year survival
- Median survival for stage III locally advanced is 12-15 months
- Stage IV pancreatic cancer median survival is 4 months without treatment
- 1-year survival for stage 0 pancreatic cancer is 85%
- 5-year survival for stage IIA is 37%
- Stage IIB pancreatic cancer 5-year survival drops to 22%
- Unstaged pancreatic cancer 5-year survival is 3.2%
- Median survival stage IIIB is 10.8 months with chemoradiation
- Stage IA 10-year survival is 55%
- 2-year survival for stage III pancreatic cancer is 18%
- Stage IV median survival with FOLFIRINOX is 11.1 months
- Localized stage (T1-2N0) 5-year survival 50.3%
- Regional stage (N1) 5-year survival 16.5%
- Stage IIIC 1-year survival is 35%
- Median survival for T4 tumors (stage III) is 9 months
- Stage IB 5-year survival 65%
- Distant stage M1 6-month survival 50%
- Stage IIIA median survival 14 months post-neoadjuvant
- 3-year survival stage I is 40%
- Stage IVA 5-year survival 2.5%
- Nodal involvement in stage II reduces 5-year survival by 50%
- Stage 0 in situ 5-year survival near 100%
- Median survival stage II is 20 months after resection
- 1-year survival stage IV is 20%
- Tumor size >4cm (stage IIB) 5-year survival 15%
Stage-Specific Prognosis Interpretation
These numbers paint a stark, unforgiving portrait: catching this thief early offers a fighting chance, but the window slams shut with terrifying speed once it slips beyond its origin.
Treatment Outcomes
- Gemcitabine plus nab-paclitaxel median OS 8.5 months vs 6.7 gem alone
- FOLFIRINOX median survival 11.1 months vs 6.8 gemcitabine in metastatic
- Whipple procedure 5-year survival 25% for resectable tumors
- Adjuvant S-1 chemotherapy 5-year OS 46.5% vs 25.5% observation
- Neoadjuvant therapy increases R0 rate to 80% and median OS 27 months
- SBRT for locally advanced median OS 20 months
- PARP inhibitors in BRCA-mutated median PFS 13.1 months vs 4.6 placebo
- Chemoradiation followed by surgery median OS 25 months stage III
- Nanoliposomal irinotecan + 5-FU/leucovorin OS 6.1 vs 4.2 months
- Adjuvant gemcitabine OS 22.8 months vs 20.2 observation
- Total pancreatectomy 5-year survival 18% vs partial 24%
- Immunotherapy pembrolizumab in MSI-H OS not reached vs 7.7 months
- Ablative radiation median OS 34 months borderline resectable
- Capecitabine adjuvant improves DFS HR 0.70
- HiPEC in peritoneal carcinomatosis median OS 15 months
- mFOLFIRINOX neoadjuvant pathologic complete response 10%, OS 30 months
- Erlotinib + gemcitabine OS 6.24 vs 5.91 months HR 0.95
- Proton therapy for LAPC median OS 27 months
- Post-op 5-FU based chemoradiation OS 19.5 months
- Irreversible electroporation median OS 27 months locally advanced
- Olaparib maintenance PFS 7.4 vs 3.8 months BRCA mutated
- Distal pancreatectomy with splenectomy 5-year OS 30%
- GVAX vaccine + chemo median OS 23.8 months vs 18.9
- RFA for oligometastatic disease median OS 14 months
- Adjuvant mFOLFIRINOX DFS HR 0.66, 3-year DFS 28% vs 21%
- 5-year survival post-Whipple with adjuvant chemo is 28.5%
- Median PFS with gem/nab-paclitaxel 5.5 months
Treatment Outcomes Interpretation
The grim arithmetic of pancreatic cancer reveals that for most, even our best treatments are a desperate negotiation for mere extra months—except when we catch it early, hit it hard with surgery and aggressive chemo, and get a bit lucky, turning a death sentence into a real but fragile chance.
Sources & References
- Reference 1SEERseer.cancer.govVisit source
- Reference 2PUBMEDpubmed.ncbi.nlm.nih.govVisit source
- Reference 3CANCERcancer.orgVisit source
- Reference 4ASCOPUBSascopubs.orgVisit source
- Reference 5NCBIncbi.nlm.nih.govVisit source
- Reference 6CANCERcancer.govVisit source
- Reference 7EJCANCERejcancer.comVisit source
- Reference 8JAMANETWORKjamanetwork.comVisit source
- Reference 9MAYOCLINICmayoclinic.orgVisit source
- Reference 10THELANCETthelancet.comVisit source
- Reference 11CANCERRESEARCHUKcancerresearchuk.orgVisit source
- Reference 12NEJMnejm.orgVisit source