Facing the stark reality that pancreatic cancer's five-year survival stands at just 12.5% reveals an urgent battle against time, but peeling back the statistics uncovers the specific factors and modern treatments that are rewriting patient outcomes, from an 11-month median survival with standard chemotherapy for metastatic cases to a promising 93% survival rate for localized neuroendocrine tumors.
Key Takeaways
- The 5-year overall survival rate for pancreatic cancer patients diagnosed in the US from 2014-2020 is 12.5%
- The median overall survival for metastatic pancreatic ductal adenocarcinoma (PDAC) is 11 months with standard chemotherapy
- 1-year survival rate for all stages of pancreatic cancer is approximately 25-30%
- Localized pancreatic cancer has a 5-year survival of 44.3%
- Regional stage pancreatic cancer 5-year survival is 16.2%
- Distant metastatic pancreatic cancer 5-year survival is 3.2%
- Neoadjuvant chemotherapy improves survival in resectable PDAC to 30 months median
- FOLFIRINOX regimen yields median OS of 11.1 months in metastatic PDAC
- Gemcitabine alone median OS 5.7 months in advanced PDAC
- Men have a 5-year pancreatic cancer survival rate of 11.8% vs 12.9% for women
- African American patients 5-year survival 10.5% vs 13.2% for whites
- Patients aged 65-74 have median survival of 8 months for PDAC
- High CA19-9 levels >1000 U/mL predict median OS 6 months
- Positive lymph node ratio >0.25 associated with HR 2.1 for death
- KRAS mutation present in 90% PDAC worsens prognosis HR 1.4
Pancreatic cancer survival remains very low, though early detection can significantly improve it.
Overall Survival Rates
- The 5-year overall survival rate for pancreatic cancer patients diagnosed in the US from 2014-2020 is 12.5%
- The median overall survival for metastatic pancreatic ductal adenocarcinoma (PDAC) is 11 months with standard chemotherapy
- 1-year survival rate for all stages of pancreatic cancer is approximately 25-30%
- The 5-year survival rate for pancreatic neuroendocrine tumors (PNETs) is 53% compared to 11% for exocrine tumors
- Overall survival at 3 years for resected pancreatic cancer is 20-25%
- Median survival for unresectable pancreatic cancer is 6-9 months without treatment
- 5-year survival for pancreatic cancer improved from 5% in 1990s to 12% in 2020s
- Overall survival rate at 2 years is 18% for PDAC patients
- The 10-year overall survival for pancreatic cancer is less than 5%
- Median overall survival for stage IV PDAC is 6.7 months with FOLFIRINOX
- The 5-year survival rate for localized pancreatic cancer is 44%
- Median OS for all pancreatic cancer patients is 11 months per SEER 2015-2021
- 3-year overall survival for PDAC is 15%
- Survival for functional PNETs 5-year 65% vs non-functional 55%
- Untreated pancreatic cancer median survival 3-6 months
- 5-year OS for cystic neoplasms resected 70-90%
- Historical 5-year survival 6% pre-2000, now 12%
- 18-month OS rate 25% in contemporary cohorts
- Long-term survivors >5 years 7% of PDAC cases
- Median OS stage IV 4.6 months gemcitabine era
Overall Survival Rates Interpretation
While the numbers paint a stark and often grim picture of pancreatic cancer, they also quietly underscore a critical truth: every percentage point of improvement represents hard-won progress, reminding us that behind the daunting statistics lies both the urgency for better treatments and the resilience of those fighting this disease.
Stage-Specific Survival
- Localized pancreatic cancer has a 5-year survival of 44.3%
- Regional stage pancreatic cancer 5-year survival is 16.2%
- Distant metastatic pancreatic cancer 5-year survival is 3.2%
- Stage IA pancreatic cancer 5-year survival exceeds 60% post-resection
- Stage IIB PDAC has median survival of 24 months after surgery
- Stage III locally advanced pancreatic cancer median survival is 12-15 months
- Stage IV pancreatic cancer 1-year survival is 20%
- Resectable stage pancreatic cancer 5-year survival is 28%
- Borderline resectable PDAC stage survival at 3 years is 35%
- Unresectable stage III PDAC median OS is 11.1 months with chemoradiation
- 5-year survival for stage-localized PNETs is 93%
- Stage II pancreatic adenocarcinoma 5-year survival is 15.4%
- Stage III PDAC 2-year survival is 25%
- Stage 0 pancreatic cancer in situ 5-year survival approaches 100%
- Median survival for stage I resected PDAC is 32 months
- 5-year survival post-resection for stage I/II PDAC is 21%
- Advanced stage IV PDAC 6-month survival is 50%
- Localized exocrine pancreatic cancer 3-year survival is 50%
- Median OS for T1N0M0 stage PDAC is 50 months
- Whipple resection for early stage improves 5-year survival to 40%
- Stage II survival 5-year 14.8%
- Median survival stage III unresectable 10.8 months
- 1-year survival distant stage 18.9%
- T2N0 stage median OS 40 months post-surgery
- Stage IB PDAC 5-year 50%
- Locally advanced median OS 13 months FOLFIRINOX
- Metastatic 3-month survival 70%
- Early stage resectable 3-year OS 40%
- Stage IIIB 2-year survival 18%
- AJCC 8th edition stage I 5-year 68%
- Functional stage localized PNET 5-year 97%
- Stage III 5-year 4.5%
- T3N1 stage median 20 months
- Tis stage 5-year nearly 100%
- Stage I median OS 28 months
- N+ stage vs N0 5-year 12% vs 35%
- M1 distant 5-year 3%
- Stage IIIC median OS 15 months
Stage-Specific Survival Interpretation
Pancreatic cancer teaches a brutal lesson: success hinges entirely on catching the disease whisper-quiet, as survival plunges from a near-certain win to a vanishingly slim chance the moment it decides to make its presence known.
Survival Prognostic Indicators
- High CA19-9 levels >1000 U/mL predict median OS 6 months
- Positive lymph node ratio >0.25 associated with HR 2.1 for death
- KRAS mutation present in 90% PDAC worsens prognosis HR 1.4
- Tumor size >4cm median OS 12 months vs 24 months <2cm
- SMAD4 loss correlates with 5-year survival <5%
- Perineural invasion present HR 1.6 for recurrence
- High Ki-67 proliferation index >20% median OS 15 months
- ECOG performance status 2+ median OS 4 months vs 12 months PS0
- Neutrophil-to-lymphocyte ratio >4 predicts poor OS HR 1.8
- Microvascular invasion worsens 5-year survival to 10%
- TP53 mutation HR 1.3 for mortality in resected PDAC
- Low albumin <3.5 g/dL at diagnosis median OS 7 months
- R1 resection margin positive 2-year survival 20% vs 50% R0
- Elevated LDH > upper normal limit HR 1.5 for death
- LNR >0.4 median DFS 10 months post-resection
- BRCA2 mutation improves response but OS HR 0.9 in targeted therapy
- Comorbid hypertension increases mortality HR 1.2
- High Glasgow Prognostic Score 2 median OS 5 months
- pCR after neoadjuvant HR 0.4 for death
- Elevated CRP >10 mg/L poor prognosis HR 1.7
- Platelet-to-lymphocyte >150 HR 1.6
- G12D KRAS subtype median OS 14 months
- Tumor grade 3/4 5-year 8%
- LVI present median OS 16 months
- CDKN2A alteration HR 1.5
- PS 1 median OS 9 months
- NLR >5 HR 2.2 metastatic
- Margin <1mm 3-year 25%
- PIK3CA mutation OS benefit with everolimus
- Weight loss >10% at diagnosis OS 5 months
- >20 LN harvested improves OS HR 0.7
- Bilirubin >2 mg/dL HR 1.4
- Exon 2 KRAS worse prognosis
- Charlson comorbidity 2+ HR 1.4
- GPS 1 median OS 8 months
- Pathologic downstaging OS 40 months median
- Fibrinogen >4 g/L HR 1.9
- Sarcopenia at diagnosis HR 1.6
Survival Prognostic Indicators Interpretation
Pancreatic cancer whispers its grim prognosis through a chorus of clinical findings, where even a single negative factor like sky-high CA19-9 or ailing performance can sharply cut survival time, while the rare glimmer of hope—like a pathological complete response—stands as a defiant but lonely exception against a relentless statistical tide.
Survival by Demographics
- Men have a 5-year pancreatic cancer survival rate of 11.8% vs 12.9% for women
- African American patients 5-year survival 10.5% vs 13.2% for whites
- Patients aged 65-74 have median survival of 8 months for PDAC
- Hispanic pancreatic cancer patients 5-year survival 13.5%
- Women under 50 have 5-year survival of 25% vs 15% for men same age
- Asian/Pacific Islander 5-year survival 15.1% for pancreatic cancer
- Elderly >80 years median OS 3 months for metastatic PDAC
- Urban residents survival higher by 2% than rural in pancreatic cancer
- Smokers have 20% lower 5-year survival than non-smokers
- Obese patients BMI>30 median OS 7.2 months vs 9.5 months normal weight
- Diabetic patients 5-year survival 10% lower than non-diabetics
- Socioeconomic status low quintile survival 9% vs 14% high quintile
- Young adults <40 years 5-year survival 20-30% post-resection
- Male gender HR 1.15 for mortality in PDAC adjusted analysis
- American Indian/Alaska Native 5-year survival 11.2%
- Patients with insurance 5-year survival 13% vs 8% uninsured
- Median survival longer by 4 months in high-volume hospitals
- Female gender improves OS by 1.5 months median in metastatic PDAC
- Age <65 years 2-year survival 22% vs 12% >65 years
- Women aged 45-64 5-year survival 18%
- Black females survival 11.1% 5-year
- Age 45-54 median OS 12 months
- White males 5-year 11.5%
- Rural patients OS shorter by 1.8 months
- Former smokers survival HR 1.2
- BMI 25-30 median OS 8.8 months
- New-onset diabetes within 3 years prior diagnosis worse OS
- Lowest SES 1-year survival 22%
- Adolescents 15-19 5-year 25%
- Asian females 5-year 16.2%
- Medicaid insured OS HR 1.25
- High volume center resection OS 32 months median
- Males >75 years 5-year 5%
- Hispanic males survival 12.8%
- Alcohol use >3 drinks/day HR 1.3 mortality
- ECOG 0 young patients 5-year 30%
Survival by Demographics Interpretation
These statistics paint a grim, unequal portrait where the dice of pancreatic cancer survival are loaded by who you are, where you live, and the size of your wallet.
Survival by Treatment Modality
- Neoadjuvant chemotherapy improves survival in resectable PDAC to 30 months median
- FOLFIRINOX regimen yields median OS of 11.1 months in metastatic PDAC
- Gemcitabine alone median OS 5.7 months in advanced PDAC
- Adjuvant gemcitabine post-resection extends 5-year survival to 23.5%
- Stereotactic body radiotherapy (SBRT) for locally advanced PDAC median OS 19.2 months
- Gemcitabine + nab-paclitaxel median OS 8.5 months in metastatic disease
- Surgical resection alone 5-year survival 18-20% in PDAC
- Chemoradiation followed by surgery improves OS to 27 months in borderline resectable
- Immunotherapy with checkpoint inhibitors shows 1-year OS of 20% in MSI-high PDAC
- Targeted therapy with PARP inhibitors in BRCA-mutated PDAC median OS 19.4 months
- Palliative radiation extends survival by 2-3 months in advanced cases
- CONKO-001 trial adjuvant chemo 5-year OS 21% vs 12% observation
- PRODIGE-24 trial FOLFIRINOX adjuvant median DFS 21.6 months
- Irreversible electroporation for locally advanced median OS 24 months
- Erlotinib + gemcitabine median OS 6.24 months vs 5.91 months gem alone
- HiPEC in peritoneal carcinomatosis median OS 14.3 months
- Neoadjuvant FOLFIRINOX median OS 37 months in resectable PDAC
- 5-FU based chemoradiation median OS 16.5 months locally advanced
- Adjuvant S-1 chemotherapy median OS 46.5 months Japan
- Nanoliposomal irinotecan + 5-FU median OS 6.1 months
- Capecitabine adjuvant 5-year OS 28%
- Proton therapy locally advanced median OS 27 months
- Olaparib maintenance median PFS 7.4 months BRCA
- R0 resection 5-year 25%
- Total neoadjuvant therapy median OS 25 months borderline
- Pembrolizumab MSI-H median OS not reached at 2 years
- Best supportive care median OS 2.6 months
- mFOLFIRINOX median OS 12 months metastatic
- ESPAC-4 trial gemcap vs gem OS 28 vs 25.5 months
- IORT intraoperative RT median OS 21 months
- Liposomal irinotecan second-line OS 6 months
- Preoperative chemoradiation OS 5-year 42%
- GVAX vaccine trial median OS 3.9 months vs 2.6 placebo
Survival by Treatment Modality Interpretation
The sobering reality of pancreatic cancer is that, despite this arsenal of options offering incremental victories, each month of survival is a hard-won battle against a formidable enemy.
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