Ten years of experience in patients with resected pancreatic tumors: Real-world data in a public institution in Peru.

Abstract

686 Background: In Peru, the incidence of pancreatic tumors is 3.59 per 100,000 inhabitants, being the ninth cause of death. The standard of treatment in the world is surgery, achieved in 13% of patients, with overall survival (OS) and disease-free survival (PFS) at 5 years of 10% and 34%, respectively. In our study, the different subtypes of pancreatic tumors that were resected by surgery, their clinical/pathological characteristics, OS and PFS were evaluated. Methods: A retrospective review was carried out, in patients older than 18 years, diagnosed and treated with first intention surgery, during 2010 - 2019. 36.9% were adenocarcinoma (AD), 36.2% solid pseudopapillary neoplasm, 20.6% serous cystadenoma, 3.5% intraductal papillary mucinous neoplasm, 2.1% mucinous cystic neoplasm, and 0.7% acinar cell carcinoma. The Kaplan Meir method was used to estimate OS and PFS, and the log-rank test to differentiate between estimated curves. Results: 141 patients with resected pancreatic tumors; 73.8% without comorbidities and 2.1% with Diabetes Mellitus. Jaundice at debut was present in 22.7%, of whom 60% were AD; with OS at 5 years, 23.7% of patients with jaundice vs 69.9% without jaundice, 55.3% of tumors were located in the head of pancreas, 78.8% were AD; an OS at 5 years of 50.1% vs 67.3% of not located in the head of the pancreas. According to staging (S), 14.2% S I, 43.3% S IIA, 20.6% S IIB, and 22% S III; 100% were AD in S IIB-III vs 8.9% non-AD, with OS at 5 years S III of 16.2% and IIB of 39.3%. OS and PFS at 5 years, in pancreatic tumors were 57.7% and 73.5%, respectively. For patients with AD, the OS and PFS were 22.9% and 36.9%, respectively. Conclusions: The study suggests that jaundice at debut, located in head of the pancreas, S IIB-III, are worse prognostic factor in our patients with pancreatic tumors, especially in AD. And our patients with resected AD, presents greater survival compared to literature, although more evidence is still required due to the type of study.