A new study has found that nearly 40% of patients with early pancreatic cancer who could be treated with surgery do not get the operation, grimly reducing their chances of survival.

Researchers at Northwestern University Medical School (Chicago, IL, USA) conducted an analysis of a U.S. national cancer database maintained by the American College of Surgeons. The researchers found that 3,644 patients out of 9,559 with early-stage disease, or about 38%, were not offered surgery. Blacks, patients older than 65, and those with lower annual incomes and education were the least likely to be offered surgery.

The study also found that about 30% of patients with early-stage disease who undergo surgery could be expected to survive at least five years, compared with less than 5% of early-stage patients who do not get the operation. The study was published ahead of print during June 2007, in the online version of Annals of Surgery.

“The complicated operation is tricky but safer than previously thought and can extend life, although chances of surviving five years are still not great,” said study co-author Dr. Mark Talamonti, a cancer surgeon at Northwestern Memorial Hospital (Chicago, IL, USA) and chief of surgical oncology at Northwestern University. “It is still a formidable disease, but if you’re caught with early-stage disease, at least there is reasonable hope.”

Nearly all patients who survive pancreatic cancer surgery undergo an operation called the Whipple procedure. This seven- to eight-hour surgery includes removing most or all of the pancreas, part of the intestine, the entire gallbladder, and part of a bile duct.

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