Abstract
Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.
Highlights
Pancreas cancer is not common in Malaysia, which probably reflects diagnostic capacity rather than the actual incidence
Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival
Studies have showed that tumour with size greater than 1 cm had a significantly lower 5-year survival rate
Summary
Pancreas cancer is not common in Malaysia, which probably reflects diagnostic capacity rather than the actual incidence. The sex ratio in Malaysia was 1.6:1 (M:F) and the Chinese had higher incidence rate compared to the other ethnic groups. It is a disease of older people with the incidence increasing after 50 years of age (Zainal and Zainudin, 2006). The incidence of pancreas cancer increases with age and is more common among men (Ghadirian and Lynch, 2003; Luke et al, 2009). The incidence of pancreatic cancer is higher in more developed countries than the less developed ones (Lowenfels and Maisonneuve, 2002)
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