Factors affecting survival in pancreatic carcinoma: Analysis from a oncology unit of a general hospital in Peru

Abstract

15184 Background: Pancreatic carcinoma (PC) is one of the most devasting neoplasm , usually diagnosed in advanced stage with a poor outcome . We present the experience in a Medical Oncology Unit in a National General Hospital, analysing the risk factors for survival in PC. Methods: This is a retrospective study with data collected on 224 patients with PC in all stages between 1999 and 2004. Only 82 patients were included because the rest had clinical and radiological diagnosis without histological studies. Survival was calculated using the Kaplan-Meier method. Clinical, surgical and histopathological records were examined by univariate and multivariate analysis to identify the independent prognostic predictors of survival. Results: All of patients had a confirmed hystopathologic diagnosis of PC. Median age was 69 years ( 33–87), 38/82 (46%) were women; 65/82 (79%) had tumor localized in pancreas head and 22/82 (26%) were stage I /II . 60/80 ( 73%) had advanced stages III/IV. Only 19/82 ( 23%) had Whipple surgery with curative intent. On diagnosis Performance status(PS). 2- 4 was present in 56% (46) .For different reasons only 16/82 received treatment based in gemcitabine. Median overall survival for all patients was 5.4 months, with 1 year survival of 32% .On univariate analysis, P.S. ( p=0.077), Whipple surgery with curative intent (p=0.026), Gemcitabine treatment (p=0.002) and CEA ( p=0.002) significantly influence survival. On multivariate analysis, only P.S (p< 0.05), Gemcitabine based treatment ( p=0.005) and CEA ( p= 0.045) independently influence survival. Conclusions: In this retrospective analysis we identified performance status, CEA and Gemcitabine based treatments as independent prognostic factors that influence survival in PC, adressing the role of standar gemcitabine regimens in the treatment of advanced PC and the need of continue research for improve the outcome of this challenging disease. No significant financial relationships to disclose.