Pancreatic Adenocarcinoma: Experience at the National Oncologic Institute of Panama, 2013-2018

Abstract

Introduction: Pancreatic adenocarcinoma ranks sixth in cancer mortality in Panama. In our country there is no literature that describes pancreatic adenocarcinoma in patients treated at the National Oncologic Institute Nacional (ION). Methods: A descriptive study was carried out from medical records, which included all patients with a diagnosis of pancreatic adenocarcinoma treated at the ION, from January 2013 to December 2018. We describe the sociodemographic and clinical characteristics, referring to the diagnosis, staging and management of pancreatic adenocarcinoma. The tabulation and statistical analysis was carried out with the Microsoft Excel Office 365 © program. Results: 388 files were reviewed, of which 284 met the inclusion criteria. 52% were male and 48% female, the average age was 65 years (± 11.7 years). The most frequent symptoms at the time of diagnosis were abdominal pain (73%) and weight loss (70%). 70% presented in stage IV and only 5% with resectable disease. 21 surgical interventions were performed with a curative intent. The palliative approach was used as initial treatment in 253 patients; 18 patients in radiotherapy, 80 in palliative care unit and 155 in systemic therapy. 28% of the patients were treated without histological confirmation. 27.8% had Ca19-9 values below 37U/mL, 28.5% over 1000 U/mL and 16.5% were not tested. Conclusions: Approximately 50 patients with pancreatic adenocarcinoma are evaluated at the institution per year, and only 5% present with resectable disease. Two thirds of the patients presented with distant metastases at the time of diagnosis, this representing poor prognosis.