Underestimation of pancreatic cancer in the national cancer registry – Reconsidering the incidence and survival rates

Fest, Jesse; Ruiter, Rikje; Rooij, Frank J.A. van; Geest, Lydia G. M. van der; Lemmens, Valery; Ikram, M. Arfan; Coebergh, Jan Willem; Stricker, Bruno H. Ch.; Eijck, Casper H.J. van

doi:10.1016/j.ejca.2016.11.026

Cited by 48 publications

(40 citation statements)

References 11 publications

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“…The shorter survival of our patients may be related to a more advanced stage at presentation and a higher incidence of liver involvement with hepatic decompensation. On the other hand, Fest et al reported a median survival of 71 days which is shorter than that reported in our study 17 . There was no statistically significant relation between both age and gender and survival.…”

Section: Discussioncontrasting

confidence: 92%

“…The age of pancreatic cancer patients varied between studies. The mean age of our patients was 59 years, which is similar to that reported by Vasen 17,18 . Similar to the findings of other studies [16][17][18] , our patients were predominantly males.…”

Section: Discussionsupporting

confidence: 88%

“…The mean age of our patients was 59 years, which is similar to that reported by Vasen 17,18 . Similar to the findings of other studies [16][17][18] , our patients were predominantly males. Other pancreatic malignancies may be more common in females, like mucinous cystadenocarcinoma 19 .…”

Section: Discussionsupporting

confidence: 88%

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Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Gohar

Megahid

Rizk

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Pancreatic carcinoma is an uncommon tumor with a high mortality rate. Because of the late presentation of the disease, only a small percent of patients are candidate for surgery. Aim: To assess the epidemiology and the clinical outcome of patients diagnosed with pancreatic adenocarcinoma presented to the Clinical Oncology Department at Menoufia University. Methods: All patients presenting with exocrine pancreatic carcinoma from January 2007 to December 2011 were included. Epidemiological features of patients and their treatment details and outcome were collected retrospectively from the medical records. An equal number of matched controls were interviewed and filled a questionnaire to identify possible risk factors. Results: Exocrine pancreatic adenocarcinoma represented 1.4 % of all cancer patients treated at our institution. The study included 76 patients and 76 controls. Pancreatic cancer patients were significantly more likely to be overweight when compared to controls (OR= 2.51, 95%CI: 1.04-6.06). Diabetes mellitus and smoking were significantly more prevalent among patients (OR= 2.36, 95%CI: 1.23-4.54; OR= 2, 95%CI: 1.05-3.81; respectively). The median time to progression was 12 weeks (95%CI: 9.46-14.53) and the median overall survival was 16 weeks (95%CI: 12.22-19.78). Patients with earlier tumor stage and those who underwent surgery followed by adjuvant chemotherapy had significantly better overall survival (p=0.02 and <0.001, respectively). Conclusion: Exocrine pancreatic adenocarcinoma is an uncommon tumor among cancer patients treated at the Clinical Oncology Department of Menoufia University. Diabetes mellitus, higher body mass index and smoking are significantly more prevalent in pancreatic carcinoma patients. Earlier tumor stage and undergoing surgery followed by chemotherapy are associated with statistically significant better overall survival.

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

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Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Gohar

Megahid

Rizk

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…[22][23][24][25][26][27][28] However, other literature data reported higher average age (67-77 years). [29][30][31][32] In accordance with the results of other studies, the patients were predominantly males. This is due to, at least in part, increased cigarette smoking and alcohol consumption in males.…”

Section: Discussionsupporting

confidence: 82%

Pancreatic ductal adenocarcinoma in a Moroccan population: analysis of six years experience

et al. 2018

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Background: Few studies have been done to investigate pancreatic cancer in Morocco. Therefore, the aim of our study was to describe the epidemiological, clinical and therapeutic features of pancreatic ductal adenocarcinoma in Moroccan population.Methods: Author retrospectively reviewed the medical data of pancreatic ductal adenocarcinoma patients presented to the Medical Oncology Department of the Military Hospital Moulay Ismail in Meknes, Morocco, from January 2011 to December 2016.Results: The study included 67 cases of pancreatic ductal adenocarcinoma. The mean age of patients was 61.24±10.35 years. Male/female ratio was 3.2/1. 20.9% of patients were cigarette smokers, 10.5% alcoholics. 23.9% diabetics, 3.0% with a positive family history of pancreatic cancer and 25.4% with a family history of diabetes mellitus. The main symptoms for consultation were weight loss (68.6%), abdominal pain (64.2%), jaundice (53.7%) and vomiting (25.4%). The tumour was located to the pancreatic head in 71.6% of cases. Stage IV disease was the most common stage representing 47.8% of patients. Biliary and duodenal stent placements were respectively performed in 10.4% and 3.0% of patients. 23.9% of patients underwent curative surgery, 7.5% had palliative surgery and 86.6% received chemotherapy. The median overall survival for the entire cohort was 9.3 months (95% CI 7.2-12.1 months) with a median follow-up of 9.7 months (2-63 months).Conclusions: The data on pancreatic ductal adenocarcinoma in Moroccan population are similar to the epidemiologic literature data. With multimodality treatments, the results in terms of survival benefit seem to be similar to those in Asian and Caucasian populations.

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“…The proportion of patients not receiving TTT in particular could be underestimated in the NCR, since among unregistered patients pathological confirmation is lower and survival is significantly poorer, as was demonstrated in a recent Dutch study [40]. It is plausible that in these patients it was decided to abstain from pathological confirmation and TTT, because of poor clinical condition or poor prognosis.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Patient characteristics and treatment considerations in pancreatic cancer: a population based study in the Netherlands

et al. 2018

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Background: Pancreatic cancer carries a poor prognosis. To date, there has been little research devoted to decision-making regarding treatment options in pancreatic cancer, including the rationale for choosing to withhold tumor targeting treatment (TTT). This study aims to gain insight into the characteristics of patients receiving no TTT, the reasons for this decision and their survival. Methods: All patients diagnosed in the Netherlands between 1 January 2014 and 30 June 2015 with a proven pancreatic adenocarcinoma or a pathologically unverified pancreatic tumor were identified in the Netherlands Cancer Registry. Information on initial management, patient characteristics, main reasons for no TTT (as reported in medical charts) and survival were analyzed. Results: A total of 3090 patients was included. Of these patients, 1818 (59%) received no TTT. Median age of no TTT patients was 74 years (range 35-99) versus 66 years (30-87) for TTT patients. In the no TTT group 77% had a clinical stage III/IV versus 57% of patients who received TTT. Main reasons for not starting TTT were patient's choice (27%) and extensive disease (21%). Median survival of patients who did not receive TTT was 1.9 months, ranging from a median survival of 0.8 months (when main reason to withhold TTT was short life expectancy) to 4.4 months (main reason to withhold TTT: old age). In the latter group, a relatively large proportion of clinical stage I tumors was present (37%). Conclusion: The majority of patients with pancreatic cancer received no TTT and had a very poor median survival. In most patients, patient's choice not to start treatment was the main reason for withholding treatment, suggesting patient's involvement in decision-making.

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Underestimation of pancreatic cancer in the national cancer registry – Reconsidering the incidence and survival rates

Cited by 48 publications

References 11 publications

Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Pancreatic ductal adenocarcinoma in a Moroccan population: analysis of six years experience

Patient characteristics and treatment considerations in pancreatic cancer: a population based study in the Netherlands

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