Pancreatic Carcinoma: the Disease that Kills

Kabashi, Serbeze; Dedushi, Kreshnike; Ramadani, Naser; Muçaj, Sefedin; Hoxhaj, Asrtrit; Jerliu, Naim

doi:10.14740/wjon954w

Cited by 9 publications

(11 citation statements)

References 7 publications

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“…However, the median survival time of PDAC is less than 17 months, and so the model is not suitable for majority patients with pancreatic cancer [ 9 ]. The nomogram developed by Brennan et al [ 5 ] included a large number of variables, such as tumor margins on resection, patient weight loss, and portal vein resection in the study, but the C-index of the model was 0.64, which may be explained by the fact that the study included distal PDAC which has a worse prognosis that PDAC of the head of the pancreas [ 18 ]. The nomogram established by Xu et al [ 11 ] showed high predictive accuracy for the prognosis of PDAC, but the development of the model was based on data from a single center with a small study population, and the standard values of the variables were inconsistent.…”

Section: Discussionmentioning

confidence: 99%

A Prognostic Nomogram for Disease-Specific Survival in Patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas Following Pancreaticoduodenectomy

Zhou

Zhao

2018

Med Sci Monit

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BackgroundThis study developed and validated a nomogram to predict patient prognosis for pancreatic ductal adenocarcinoma (PDAC) of the head of the pancreas following pancreaticoduodenectomy.Material/MethodsRetrospective data were obtained from 4,383 patients with PDAC of the head of the pancreas who underwent pancreaticoduodenectomy between 2004–2013 from 11 Registries Research Data of the Surveillance, Epidemiology,and End Results (SEER) database. Cox proportional hazards model was used to identify independent risk factors. The predictive accuracy of the nomogram was determined by the concordance index (C-index) and calibration curve. The results were externally validated by comparison with data from 1,743 patients from 7 other Registries Research Data.ResultsOf the 4,383 patients in the training dataset, median disease-specific survival (DSS) was 17.0 months (range, 1.0–131 months), and postoperative 1-year, 3-year, and 5-year DSS rates were 70.3%, 26.1%, and 16.8%, respectively. Multivariate analysis showed that patient sex, age, tumor grade, regional lymph nodes examined, positive regional lymph nodes, tumor size, extent of local invasion, and tumor metastases were independent risk factors for DSS. The C-index of the internal validation dataset for prediction of DSS was 0.64 (95% CI, 0.63–0.65), which was superior to the American Joint Committee on Cancer (AJCC) staging, 0.57 (95% CI, 0.56–0.58) (P<0.001). The 5-year DSS rates and median DSS time for patients in the low-risk group were significantly greater compared with high-risk group (P<0.001).ConclusionsA validated prognostic disease-specific nomogram for patient survival in PDAC of the head of the pancreas following pancreaticoduodenectomy was developed.

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Section: Discussionmentioning

confidence: 99%

A Prognostic Nomogram for Disease-Specific Survival in Patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas Following Pancreaticoduodenectomy

Zhou

Zhao

2018

Med Sci Monit

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“…In contrast, pancreatic carcinomas arising from the tail are less common and present later, usually with abdominal pain, back pain, and weight loss. Pancreatic cancer of the tail is often undiagnosed or misdiagnosed and thus is associated with a higher mortality rate due to its frequent late presentation [3, 4, 7, 8]. An earlier diagnosis depends on a better understanding of the clinical course of the disease; however, much of the current literature focuses on pancreatic head adenocarcinomas due to their higher incidence.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 75% of all pancreatic carcinomas arise in the head of the pancreas; 15–20% arise in the body; and 5–10% arise in the tail [4]. Previous research has demonstrated meaningful differences in presentation and mortality between carcinomas arising in the pancreatic head versus in the pancreatic body and tail [5].…”

Section: Introductionmentioning

confidence: 99%

The seemingly innocuous presentation of metastatic pancreatic tail cancer: a case report

Rahman

Washington²

2019

J Med Case Reports

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Background Pancreatic cancers of the tail have an especially poor prognosis due to their late detection. An earlier diagnosis depends on a better understanding of the clinical course of the disease; however, much of the current literature focuses on pancreatic head adenocarcinomas owing to their higher incidence. Thus, we add our case report to the current literature of pancreatic tail cancers in the hope of aiding earlier detection. We present an interesting case of a patient who initially presented with innocuous abdominal pain and a single episode of vomiting who was subsequently diagnosed with metastatic pancreatic tail cancer. Case presentation A 56-year-old Hispanic man with a past medical history of alcohol and cocaine abuse was initially evaluated in our clinic after presenting to the emergency department with sudden onset of abdominal pain and one episode of emesis. On further questioning, he stated that he had been experiencing dull, intermittent left back pain for the past 2–3 years. Laboratory tests were performed, which showed that the patient had new-onset diabetes, and imaging revealed a pancreatic tail mass with metastases to the liver. Biopsy confirmed the diagnosis of stage IV metastatic pancreatic tail adenocarcinoma. During follow-up 1 month later, the patient reported that he had been largely asymptomatic since his hospital admission; however, his left back pain had increased in severity. He was then started on a FOLFIRINOX chemotherapy regimen (5-fluorouracil/leucovorin, irinotecan, and oxaliplatin). Conclusions There are many pitfalls in the diagnosis of pancreatic cancer, especially pancreatic tail cancer due to its vague symptoms. Thus, pancreatic cancer of the tail often presents late with a very poor prognosis. Because there is currently no widespread screening for pancreatic cancer, it is often difficult for practitioners to identify pancreatic tail cancers. Current research suggests that there is a strong association between new-onset diabetes after the age of 50 and pancreatic cancer, and tumors detected at the onset of diabetes are favorable to resection. Pancreatic cancer has also been shown to be associated with certain risk factors, such as smoking, high body mass index, chronic pancreatitis, and a family history of pancreatic cancer. Thus, when patients with presentations similar to our patient’s with new-onset diabetes after the age of 50, along with vague symptoms such as back or abdominal pain as well as the presence of risk factors, we suggest that it is beneficial for practitioners to maintain a high index of suspicion for pancreatic cancer.

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“…When symptoms do arise, they are often vague and vary depending on the tumor location [2]. Around 75% of all pancreatic carcinomas are found in the head, 15%-20% in the body, and 5%-10% in the tail [3]. Old study has found significant variations in the appearance and mortality of pancreatic head carcinomas vs carcinomas of the pancreatic body and tail [4].…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of Tail of Pancreas: A Case Report

Thakare

Ankar

Sharma

et al. 2021

JPRI

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Background: A typical manifestation of pancreatic tail cancer is large intestinal obstruction with perforation. Clinically the cancer of pancreas is usually complicated to diagnose. Most cancer patients are not having symptoms throughout during the initial stages of the cancer, which often leads to a delay in diagnosis. Treatment choices include surgery, chemotherapy, and palliative care. It is more common in African-Americans, slightly more common in men. Case Presentation: A female patient of 40 years from Wardha was admitted to Female surgery Ward, Unit-3, AVBRH on 18th December with a chief complaint of pain in epigastric region since 2weeks. Patient was apparently all right 2 months back then she was complaining of pain in the epigastric region which was insidious in onset, gradually progressive in nature, burning type of pain with radiating to left upper back. No history of fever, nausea vomiting, clay-coloured stools. After that patient was undergone on routine investigation in that total WBC count was increased i.e., 13000/cu mm and haemoglobin level were decreased i.e., 9.7gm%, liver biopsy revealed that metastasis of Adenocarcinoma probably of pancreatic origin, Computed tomography and ultrasound and it revealed that heterogenous iso-echoic mass in the tail of pancreas based on investigation she was diagnosed as a case of Carcinoma tail of pancreas and she was undergone on treatment of antibiotic before chemotherapy .after that chemotherapy treatment was done for management of pain. Conclusion: Pancreatic adenocarcinoma presents differently from large intestinal cancer and should be explored in the differential diagnosis of large intestinal obstruction.

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Pancreatic Carcinoma: the Disease that Kills

Cited by 9 publications

References 7 publications

A Prognostic Nomogram for Disease-Specific Survival in Patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas Following Pancreaticoduodenectomy

A Prognostic Nomogram for Disease-Specific Survival in Patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas Following Pancreaticoduodenectomy

The seemingly innocuous presentation of metastatic pancreatic tail cancer: a case report

Carcinoma of Tail of Pancreas: A Case Report

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