Clinical Statistics and Outcomes of Pancreatic Neoplasms in Japan: A Retrospective Cohort Study using the Japan Pancreatic Cancer Registry.

The Japan Pancreatic Cancer Registry (JPCR), managed by the Japan Pancreas Society, has adopted the National Clinical Database (NCD) platform for data registration. This study aimed to describe the nationwide annual trends and clinical outcomes of pancreatic neoplasms using this NCD-based registry (NCD-JPCR) for the first time. We analyzed data from the NCD-JPCR for pancreatic neoplasms registered between 2012 and 2018. The annual epidemiological trends and survival outcomes were evaluated for major pancreatic neoplasms, including invasive ductal carcinoma (IDC). In total, 47,005 patients were registered from 1,062 departments, with approximately 600 departments contributing annually. IDC was the most common diagnosis (n=36,204; 77.0%), followed by intraductal (n=4,498; 9.6%), cystic (n=2,687; 5.7%), and pancreatic neuroendocrine neoplasms (n=2,494; 5.3%). In the survival analysis of IDC, patients who underwent resection showed a significantly longer median overall survival (mOS) in 2015-2018 than in 2012-2014 (34.5 months [n=17,328] vs. 29.7 months [n=9,623]; P<0.0001). Similarly, mOS for patients who did not undergo resection significantly improved in 2015-2018 compared with 2012-2014 (10.2 months [n=5,733] vs. 9.0 months [n=3,326]; P<0.0001). Treatment outcomes for IDC showed significant improvements from the early to the late 2010s for both patients who did and did not undergo resection. These findings may reflect nationwide progress in the multidisciplinary management of pancreatic cancer in Japan.