CLINICAL PRESENTATION, DIANGOSTIC WORKUP AND THERAPEUTIC APPROACH FOR PANCREATIC CANCER IN A TERTIARY GASTROENTEROLOGY CENTER

CANCER OF THE EXOCRINE PANCREAS IS A HIGHLY LETHAL MALIGNANCY. SURGICAL RESECTION IS THE ONLY POTENTIALLY CURATIVE TREATMENT. UNFORTUNATELY, BECAUSE OF THE LATE PRESENTATION, ONLY 15 TO 20 PERCENT OF PATIENTS ARE CANDIDATES FOR PANCREATECTOMY. THE AIM OF OUR STUDY WAS TO REVIEW THE RISK FACTORS, CLINICAL PRESENTATION, DIAGNOSTIC TOOLS AND THERAPEUTIC APPROACH OF PATIENTS WITH PANCREATIC CANCER, ADMITTED TO OUR CLINIC BETWEEN JANUARY 1ST AND DECEMBER 31ST OF 2016. WE ENROLLED TWO HUNDRED AND SIXTY EIGHT CONSECUTIVE PATIENTS. WE FOUND THAT MOST PATIENTS PRESENTED AT LEAST ONE RISK FACTOR FOR PANCREATIC NEOPLASIA, ESPECIALLY CIGARETTE SMOKING AND ALCOHOL DRINKING. MANY PATIENTS WERE DIAGNOSED IN ADVANCED STAGES OF THE DISEASE, WHEN THE TUMOR WAS LOCALLY INVASIVE OR HAD DISTANT METASTASES. THE MOST FREQUENT HISTOLOGICAL TYPE WAS ADENOCARCINOMA, FOLLOWED BY NEUROENDOCRINE TUMORS (13.36%). PATIENTS BENEFITED FROM SURGICAL, ONCOLOGICAL, AND/OR ENDOSCOPIC TREATMENT. THE MEDIAN SURVIVAL TIME WAS 8.83 MONTHS FOR ADENOCARCINOMA AND 66.34 MONTHS FOR NEUROENDOCRINE TUMORS. WE NOTED A LONGER MEDIAN SURVIVAL TIME FOR ADENOCACINOMA THAN THE EUROPEAN AVERAGE OF 4.6 MONTHS, PROBABLY DUE TO THE FACT THAN PATIENTS WERE DIAGNOSED AND TREATED BY A MULTIDISCIPLINARY TEAM, IN A TERTIARY CARE FACILITY. HOWEVER WE NEED TO DO A BETTER JOB IN IDENTIFYING HIGH RISK INDIVIDUALS AND THEN OFFERING THEM A PERSONALISED SCREENING PROGRAM, IN ORDER TO DIAGNOSE MORE PATIENTS IN POTENTIALLY CURATIVE STAGES.