Pre-operative timeline of resectable pancreatic cancer in a community setting

Abstract

Presenter: Navid Ajabshir MD | Mount Sinai Medical Center of Florida Background: Early stage pancreatic cancer is currently best-managed by surgical resection, with 5-year survival rates approaching 30% when amenable to resection and carried out in a timely fashion. Delays from symptom onset to surgical intervention can be due to a number of factors. A handful of studies have aimed to determine the maximum allowable window of time from diagnosis to treatment. Methods: This retrospective cohort reviewed the practice patterns in a community-based, tertiary care hospital, in patients who underwent pancreatic tumor resection from 2009 to 2018. Parameters investigated were time from radiographic image acquisition to surgical consultation, time from surgical consultation to resection, presenting symptomatology, and number and type of preoperative images performed. Results: In total, 135 patients were seen, evaluated, and treated with surgery at our institution. Of these, 35 patients were excluded for insufficient data. The medial number of days from diagnosis to surgical consultation was eleven days and from consult to surgical resection was also eleven days. On average, 48 days passed before a patient was initially imaged until they underwent surgical resection. The majority of patients presented with pain as one of their initial symptoms (n=58). When stratified for a presenting symptom of jaundice, patients were seen in surgical consultation six days earlier and operated on four days sooner. Patients received, on average, three imaging studies prior to resection. Of these, computed tomography was performed at least once in 89 percent of patients. Conclusion: In this study, we report the real-world time course and pre-operative expectations for patients with pancreatic cancer. Future studies should aim to highlight areas where efficiency may be improved upon.