What is the survival rate for an adult patient with stage 3 pancreatic adenocarcinoma?

Stage 3 Pancreatic Adenocarcinoma Survival Rate

Stage 3 pancreatic cancer has a median survival of 8-11 months with chemotherapy or chemoradiotherapy, with less than 5% of patients surviving 5 years. 1

Survival Statistics

• The 1-year survival rate for stage III patients is approximately 15%. 1
• The 5-year survival rate remains below 5%, with most patients experiencing disease progression despite treatment. 1
• These survival figures apply to patients receiving active treatment with chemotherapy or combined modality therapy. 1

Why Stage 3 Has Such Poor Outcomes

• Stage III disease is defined by T4 tumors that encases major blood vessels (superior mesenteric artery, celiac axis, or hepatic artery), making surgical resection impossible. 1
• The vascular involvement eliminates the only potentially curative treatment option, which is complete surgical resection. 1
• This biological reality fundamentally limits survival because systemic therapy alone cannot cure pancreatic adenocarcinoma. 1

Treatment Impact on Survival

• Chemotherapy remains the standard of care for stage III disease, with FOLFIRINOX showing improved progression-free and overall survival compared to gemcitabine alone in patients with good performance status (ECOG 0-1). 2, 1
• FOLFIRINOX achieved median overall survival of 11.1 months versus 6.8 months with gemcitabine alone in metastatic disease, though toxicity is substantial (46% grade 3/4 neutropenia, 25% grade 3/4 fatigue). 2
• Consolidation chemoradiation after several months of upfront chemotherapy may offer survival benefit only in highly selected patients with well-controlled localized disease after initial systemic therapy. 1
• Gemcitabine-based regimens remain reasonable for patients who cannot tolerate intensive combination therapy. 1

Critical Prognostic Context

• 80-85% of all pancreatic cancer patients present with advanced disease (stage III or IV) because the cancer remains asymptomatic until extensive. 1
• Not all stage III patients are equivalent—those with borderline resectable disease have different treatment options and potentially better outcomes than those with extensive vascular encasement. 1
• The overall 5-year survival rate for all pancreatic cancer stages combined is less than 5%, making it one of the deadliest malignancies. 3

Management Priorities Beyond Survival Numbers

• Do not delay palliative interventions including biliary or duodenal stenting for obstructive symptoms, as optimal symptomatic treatment plays a prime role in management. 1
• Evaluation should be symptom-driven rather than routine imaging-based, given the universally poor prognosis. 1
• Early goals of care discussions are essential to align treatment intensity with patient values and quality of life priorities. 3