CLINICAL PRESENTATION, DIANGOSTIC WORKUP ANDTHERAPEUTIC APPROACH FOR PANCREATIC CANCER INA TERTIARY GASTROENTEROLOGY CENTER

摘要

CANCER OF THE EXOCRINE PANCREAS IS A HIGHLY LETHAL MALIGNANCY. SURGICAL RESECTION ISTHE ONLY POTENTIALLY CURATIVE TREATMENT. UNFORTUNATELY, BECAUSE OF THE LATEPRESENTATION, ONLY 15 TO 20 PERCENT OF PATIENTS ARE CANDIDATES FOR PANCREATECTOMY. THEAIM OF OUR STUDY WAS TO REVIEW THE RISK FACTORS, CLINICAL PRESENTATION, DIAGNOSTIC TOOLSAND THERAPEUTIC APPROACH OF PATIENTS WITH PANCREATIC CANCER, ADMITTED TO OUR CLINICBETWEEN JANUARY 1ST AND DECEMBER 31ST OF 2016. WE ENROLLED TWO HUNDRED AND SIXTY EIGHTCONSECUTIVE PATIENTS. WE FOUND THAT MOST PATIENTS PRESENTED AT LEAST ONE RISK FACTORFOR PANCREATIC NEOPLASIA, ESPECIALLY CIGARETTE SMOKING AND ALCOHOL DRINKING. MANYPATIENTS WERE DIAGNOSED IN ADVANCED STAGES OF THE DISEASE, WHEN THE TUMOR WAS LOCALLYINVASIVE OR HAD DISTANT METASTASES. THE MOST FREQUENT HISTOLOGICAL TYPE WASADENOCARCINOMA, FOLLOWED BY NEUROENDOCRINE TUMORS (13.36%). PATIENTS BENEFITED FROMSURGICAL, ONCOLOGICAL, AND/OR ENDOSCOPIC TREATMENT. THE MEDIAN SURVIVAL TIME WAS 8.83MONTHS FOR ADENOCARCINOMA AND 66.34 MONTHS FOR NEUROENDOCRINE TUMORS. WE NOTED ALONGER MEDIAN SURVIVAL TIME FOR ADENOCACINOMA THAN THE EUROPEAN AVERAGE OF 4.6MONTHS, PROBABLY DUE TO THE FACT THAN PATIENTS WERE DIAGNOSED AND TREATED BY AMULTIDISCIPLINARY TEAM, IN A TERTIARY CARE FACILITY. HOWEVER WE NEED TO DO A BETTER JOBIN IDENTIFYING HIGH RISK INDIVIDUALS AND THEN OFFERING THEM A PERSONALISED SCREENINGPROGRAM, IN ORDER TO DIAGNOSE MORE PATIENTS IN POTENTIALLY CURATIVE STAGES.