Retrospective evaluation of demographic data, clinical features and survival of patients with pancreatic cancer

Öz

Background and Aims: This study aimed to evaluate the demographic characteristics, clinical features, and survival outcomes of patients diagnosed with pancreatic cancer. Additionally, patients diagnosed with pancreatic neuroendocrine tumors were included for comparative analysis. Materials and Methods: In this study, we retrospectively reviewed the records of 169 patients diagnosed with pancreatic cancer or pancreatic neuroendocrine tumors between January 1, 2011, and June 1, 2020, at Zonguldak Bülent Ecevit University Health Practice and Research Center. Demographic data, clinical characteristics, overall survival, and progression-free survival were analyzed. Results: Of the 169 patients, 152 (89.9%) had pancreatic cancer and 17 (10.1%) had pancreatic neuroendocrine tumors. The mean age at diagnosis was 60.7 years; 40.8% were female and 59.2% male. Median overall survival and progression-free survival for all patients were 11 and 6 months, respectively. In pancreatic cancer patients, overall survival was 10 months and progression-free survival 6 months, whereas in pancreatic neuroendocrine tumors patients, overall survival and progression-free survival were significantly longer (39 and 30 months, respectively). Eastern Cooperative Oncology Group performance status, body mass index, tumor-node-metastasis stage, surgery, and radiotherapy were significantly associated with overall survival and progression-free survival in both groups. In pancreatic cancer patients only, elevated carbohydrate antigen 19-9 levels and metastases (lymph node, liver, lung, peritoneum) negatively affected overall survival and progression-free survival. Factors such as alcohol/smoking habits, tumor size and location, chemotherapy, and biliary stenting showed no significant impact on survival in either group. Conclusion: Overall survival and progression-free survival were significantly worse in patients with pancreatic cancer compared with those with pancreatic neuroendocrine tumors. Consistent with the literature, advanced tumor–node–metastasis stage, poor ECOG performance status, and the presence of peritoneal metastasis at diagnosis had a statistically significant negative impact on both overall survival and progression-free survival in pancreatic cancer cases. In these patients, the presence of lymph node metastasis at diagnosis and elevated carbohydrate antigen 19-9 levels were found to negatively affect only overall survival. Although some studies have reported that biliary decompression provides an overall survival advantage in patients with pancreatic cancer, our study found no effect of biliary decompression on survival.

Anahtar Kelimeler

• Pancreatic cancer
• early stage
• overall survival
• progression-free survival

Pankreas kanseri tanılı hastaların demografik verileri, klinik özellikleri ve sağkalım açısından retrospektif olarak değerlendirilmesi

Öz

Giriş ve Amaç: Bu çalışmada, pankreas kanseri tanısı almış hastaların demografik verilerini, klinik özelliklerini ve sağkalım sürelerini analiz etmeyi amaçladık. Aynı zamanda, pankreatik nöroendokrin tümör tanısı almış hastalar da ayrı bir grup olarak çalışmaya dahil edilerek benzer analizler bu olgu grubu için de yapıldı. Gereç ve Yöntem: Bu çalışmada, 1 Ocak 2011 ile 1 Haziran 2020 tarihleri arasında Zonguldak Bülent Ecevit Üniversitesi Sağlık Uygulama ve Araştırma Merkezi’nde pankreas kanseri tanısıyla takip edilen 169 hastanın dosyaları retrospektif olarak incelendi. Hastaların demografik verileri, klinik özellikleri, genel sağkalım ve progresyonsuz sağkalım süreleri kaydedildi. Bulgular: Çalışmaya toplam 169 hasta dahil edildi; bunların 69’u (%40,8) kadın, 100’ü (%59,2) erkekti. Tanı anındaki ortalama yaş 60.78 yıl olarak bulundu. Ortanca sağkalım süresi 11 ay, progresyonsuz sağkalım süresi ise 6 ay olarak saptandı. Hastaların 152’sine (%89,9) pankreas kanseri, 17’sine (%10,1) ise pankreatik nöroendokrin tümör tanısı konulmuştu. Pankreas kanseri hastalarında genel sağkalım süresi 10 ay, progresyonsuz sağkalım süresi 6 ay iken; pankreatik nöroendokrin tümör hastalarında genel sağkalım 39 ay, progresyonsuz sağkalım 30 ay olarak bulundu. Hem pankreas kanseri hem de pankreatik nöroendokrin tümör hastalarında, ECOG performans durumu, vücut kitle indeksi, TNM evresi, cerrahi uygulanması ve radyoterapi alımı, sağkalım ve progresyonsuz sağkalım süreleriyle anlamlı şekilde ilişkili bulundu. Buna karşılık, sadece pankreas kanseri tanılı hastalarda karbonhidrat antijeni 19-9 düzeyleri ile lenf nodu, akciğer, karaciğer ve periton metastazlarının varlığı, sağkalım ve progresyonsuz sağkalım süreleri ile anlamlı şekilde ilişkiliydi. Alkol ve sigara kullanımı, tümör boyutu ve lokalizasyonu, kemoterapi alımı ve stent yerleştirilmesi, her iki grupta da sağkalım veya progresyonsuz sağkalım sürelerinde anlamlı bir fark göstermedi. Sonuç: Sağkalım ve progresyonsuz sağkalım süreleri, pankreatik nöroendokrin tümör hastalarına kıyasla pankreas kanseri hastalarında anlamlı derecede daha kötü saptandı. Literatürle uyumlu olarak, pankreas kanseri olgularında ileri tümör, nod, metaztaz evresi, kötü ECOG performans durumu ve tanı anında periton metastazı varlığı, hem sağkalım hem de progresyonsuz sağkalım üzerinde istatistiksel olarak anlamlı olumsuz etkiye sahipti. Bu hastalarda tanı anında lenf nodu metastazı varlığı ve yüksek karbonhidrat antijeni 19-9 düzeylerinin sadece sağkalım üzerinde olumsuz etkisi olduğu belirlendi. Bazı çalışmalarda biliyer dekompresyonun pankreas kanseri hastalarında genel sağkalım avantajı sağladığı bildirilmiş olsa da, bizim çalışmamızda biliyer dekompresyonun sağkalım üzerine herhangi bir etkisi saptanmadı.

Anahtar Kelimeler

• Pankreas kanseri
• erken evre
• genel sağ kalım
• progresyonsuz sağ kalım.

Kaynakça

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