National study benchmarks pancreatic cancer surgery outcomes across China

Pancreatic cancer is among the most aggressive malignancies, and in China it accounts for a substantial and rising share of cancer deaths. High-quality, nationwide data on surgical treatment are essential for benchmarking practice and improving outcomes, yet such data have historically been limited.

A new report was published in the Journal of Pancreatology recently. The China Pancreas Data Center (CPDC) is a national multi-center online registration system initiated with the support of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, and Chinese Medical Association. It analyzed 6,297 pancreatic cancer patients who underwent surgical treatment at 65 centers across China between January 2020 and December 2021.

The median age was 64 years, with a male-to-female ratio of 1.2:1. Abdominal pain and jaundice were the most common symptoms, and about 62.6% of patients presented with tumors in the pancreatic head or neck. Minimally invasive surgery was performed in 30.4% of cases, with a conversion rate of 24.9%. The predominant neoadjuvant and adjuvant chemotherapy regimen was nab-paclitaxel plus gemcitabine.

Surgical safety metrics were encouraging: in-hospital, 30-day, and 90-day mortality rates were 0.6%, 1.2%, and 3.1%, respectively. One-, two-, and three-year overall survival rates reached 75.8%, 53.3%, and 42.0%-figures the authors say align with established benchmarks from international high-volume pancreatic centers.

The study highlights that pancreatic cancer surgical care in China remains geographically concentrated in high-volume specialist centers, with nearly 45% of patients travelling across provincial borders for surgery. However, this pattern is driven by regional disparities, as over 99% of patients in advanced medical resource areas like Beijing and Shanghai received treatment locally. The authors emphasize the need to develop and roll out national-level benchmarks and standardized clinical protocols for pancreatic surgery across China.