Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study
Background: Pancreatic carcinoma carries a dismal prognosis. Late disease presentation at an advanced stage contributes to poor survival. Objectives: The objective of the present study was to describe the clinical presentation and treatment outcomes of patients with pancreatic cancer at our institut...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Cancer Research, Statistics, and Treatment |
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| Online Access: | http://www.crstonline.com/article.asp?issn=2590-3233;year=2023;volume=6;issue=1;spage=44;epage=51;aulast=Gupta |
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| author | Amit Gupta Deepak Rajput Shyam Karuppusamy Krishnasamy Oshin Sharma Rahul Mishra Amoli Tandon Sweety Gupta |
| author_facet | Amit Gupta Deepak Rajput Shyam Karuppusamy Krishnasamy Oshin Sharma Rahul Mishra Amoli Tandon Sweety Gupta |
| author_sort | Amit Gupta |
| collection | DOAJ |
| description | Background: Pancreatic carcinoma carries a dismal prognosis. Late disease presentation at an advanced stage contributes to poor survival.
Objectives: The objective of the present study was to describe the clinical presentation and treatment outcomes of patients with pancreatic cancer at our institution.
Materials and Methods: This was a retrospective study conducted in the Department of Surgery at the All India Institute of Medical Sciences, Rishikesh (Dehradun, Uttarakhand); a tertiary care hospital in the sub-Himalayan region of India. We included the data of 203 consecutive patients with pancreatic cancer, with both resectable and unresectable disease, who were treated at our institute from January 2017 to February 2020. The clinicodemographic profile and management outcomes were analyzed.
Results: Of the 203 patients, 125 (61.6%) were male; the mean age was 58 years (range, 35-78). Common presenting symptoms included jaundice in 65 (32%), and abdominal pain in 39 (19.2%). On contrast-enhanced computer tomography scan, the tumor originated most commonly in the pancreatic head (111 [54.7%]); adenocarcinoma was the tissue diagnosis in 200 (98.5%) cases. The disease was unresectable in 167 (82.3%) patients. There were 36 (17.7%) patients with resectable tumors who underwent Whipple's procedures. In the 167 patients with advanced pancreatic malignancy, the median overall survival was 12.8 months (95% Confidence Interval (CI), 8.4-14.4), while that for the 36 patients with resectable disease who underwent pancreaticoduodenectomy was 20.2 months (95% CI, 18.4-24.2).
Conclusion: Less than 20% of patients with pancreatic cancer have localized disease and can be offered “curative” surgery. There is an unmet need to develop novel strategies to extend survival. Possible approaches include early diagnosis and the use of neoadjuvant treatments in an attempt to increase the number of resectable cases. |
| first_indexed | 2024-03-13T10:38:48Z |
| format | Article |
| id | doaj.art-2eea7aea0437428cbbe57e4713e36666 |
| institution | Directory Open Access Journal |
| issn | 2590-3233 2590-3225 |
| language | English |
| last_indexed | 2024-03-13T10:38:48Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Cancer Research, Statistics, and Treatment |
| spelling | doaj.art-2eea7aea0437428cbbe57e4713e366662023-05-18T05:04:22ZengWolters Kluwer Medknow PublicationsCancer Research, Statistics, and Treatment2590-32332590-32252023-01-0161445110.4103/crst.crst_201_22Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational studyAmit GuptaDeepak RajputShyam Karuppusamy KrishnasamyOshin SharmaRahul MishraAmoli TandonSweety GuptaBackground: Pancreatic carcinoma carries a dismal prognosis. Late disease presentation at an advanced stage contributes to poor survival. Objectives: The objective of the present study was to describe the clinical presentation and treatment outcomes of patients with pancreatic cancer at our institution. Materials and Methods: This was a retrospective study conducted in the Department of Surgery at the All India Institute of Medical Sciences, Rishikesh (Dehradun, Uttarakhand); a tertiary care hospital in the sub-Himalayan region of India. We included the data of 203 consecutive patients with pancreatic cancer, with both resectable and unresectable disease, who were treated at our institute from January 2017 to February 2020. The clinicodemographic profile and management outcomes were analyzed. Results: Of the 203 patients, 125 (61.6%) were male; the mean age was 58 years (range, 35-78). Common presenting symptoms included jaundice in 65 (32%), and abdominal pain in 39 (19.2%). On contrast-enhanced computer tomography scan, the tumor originated most commonly in the pancreatic head (111 [54.7%]); adenocarcinoma was the tissue diagnosis in 200 (98.5%) cases. The disease was unresectable in 167 (82.3%) patients. There were 36 (17.7%) patients with resectable tumors who underwent Whipple's procedures. In the 167 patients with advanced pancreatic malignancy, the median overall survival was 12.8 months (95% Confidence Interval (CI), 8.4-14.4), while that for the 36 patients with resectable disease who underwent pancreaticoduodenectomy was 20.2 months (95% CI, 18.4-24.2). Conclusion: Less than 20% of patients with pancreatic cancer have localized disease and can be offered “curative” surgery. There is an unmet need to develop novel strategies to extend survival. Possible approaches include early diagnosis and the use of neoadjuvant treatments in an attempt to increase the number of resectable cases.http://www.crstonline.com/article.asp?issn=2590-3233;year=2023;volume=6;issue=1;spage=44;epage=51;aulast=Guptapalliationpancreatic carcinomaresectablewhipple |
| spellingShingle | Amit Gupta Deepak Rajput Shyam Karuppusamy Krishnasamy Oshin Sharma Rahul Mishra Amoli Tandon Sweety Gupta Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study Cancer Research, Statistics, and Treatment palliation pancreatic carcinoma resectable whipple |
| title | Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study |
| title_full | Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study |
| title_fullStr | Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study |
| title_full_unstemmed | Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study |
| title_short | Clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub-Himalayan region: A retrospective observational study |
| title_sort | clinical presentation and outcomes of pancreatic cancer at a tertiary care hospital in the sub himalayan region a retrospective observational study |
| topic | palliation pancreatic carcinoma resectable whipple |
| url | http://www.crstonline.com/article.asp?issn=2590-3233;year=2023;volume=6;issue=1;spage=44;epage=51;aulast=Gupta |
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