Surgical treatment of pancreatic cancer in China: Annual data report of China Pancreas Data Center (2020–2021)

Abstract Objective: The China Pancreas Data Center (CPDC) was established in 2015 with the support of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association and initiated prospective data collection in 2017. This article reports contemporary real-world evidence on surgical outcomes during 2020–2021, with the objective of assessing and refining clinical practice in pancreatic cancer care in China. Methods: Patients who underwent surgical treatment recorded in CPDC between January 2020 and December 2021 were retrospectively reviewed. Systematic analysis of real-world data encompassing demographics, medical history, comorbidities, symptoms, perioperative assessment and management, surgical interventions, postoperative complications, pathological findings, and overall survival was performed. Results: A total of 6297 pancreatic cancer patients who underwent surgical treatment from 65 centers across China were enrolled for analysis during 2020–2021. The median age was 64 years, and the male-to-female ratio was 1.2:1. Abdominal pain and jaundice were the most common symptoms. Approximately 62.6% of patients presented with pancreatic head/neck tumors, and the distribution of disease stage (I–IV) was 32.5%, 44.7%, 18.7%, and 4.1%, respectively. Minimally invasive surgery was performed in 30.4% of patients, with a conversion rate of 24.9%. Postoperative complication rates by Clavien–Dindo (I–V) were 52.6%, 33.2%, 12.7%, 1.0%, and 0.6%, respectively. The predominant neoadjuvant and adjuvant chemotherapy regimen was nab-paclitaxel plus gemcitabine (AG). The cohort’s in-hospital, 30-, and 90-day mortality rates were 0.6%, 1.2%, and 3.1%, respectively. And 1-year, 2-year, and 3-year postoperative overall survival rates were 75.8%, 53.3%, and 42.0%, respectively. Conclusions: Surgical management of pancreatic cancer in China exhibited regional and center-based concentration. The adoption of minimally invasive pancreatic surgery, surgical safety metrics, and outcomes reported herein align with established benchmarks from international high-volume pancreatic centers. Establishment and promotion of nationwide benchmarks and standardized protocols for pancreatic surgery are warranted.