Pancreatic cancer

epidemiology of a bad prognosis

Abstract

Introduction: pancreatic cancer is a particularly aggressive cancer with a poor prognosis and it is typically diagnosed at a late stage. Most cases have a lower rate of resectability (10% to 20%) as a result of certain unresectable factors at the time of diagnosis.
Objective: the study aims to provide an epidemiological description of the characteristics of unresectable pancreatic cancer, palliative treatment, global survival and procedures applied. Method: descriptive, multivariable, retrospective study of cases of unresectable cancer from January 2010 to December 2015, at the 3rd Surgical Unit of Hospital Maciel, Montevideo, Uruguay.
Results: considering the 30 unresectable patients: same sex distribution. Average age was 61 years old, cephalic in 67% of cases. 53 of patients had lost weight at the time of consultation, 52% of them evidenced locoregionallymph node involvement and 50% liver metastases and/or ascites. In 52% of cases some kind of biliary bypass was performed, surgical in 53% (63% pancreaticoduodenectomy), while the rest underwent percutaneous or endoscopic surgery. 31% of patients did not receive surgical or endoscopic treatment given the advanced stage of the condition. Average survival of surgical or endoscopic treatment was 3.7 months. Conclusions: at the time of diagnosis, 50% of the cases of pancreatic cancer presented metastases and severe nutritional compromise, evidencing locoregional indicators of unresectability or incurability. One third of the cases did not receive oncological treatment given the advanced stage of the disease. Global survival was low. All of these findings suggest it is essential to devise health policies for an early diagnosis and to increase resectability rates.