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Pancreatic cancer: Epidemiological factors, clinical characteristics, and therapeutic management: Data of an oncology center in southern Morocco
Background
Pancreatic cancer is considered one of the most aggressive cancers with poor prognosis. It is usually tardily diagnosed due to its atypical symptomatology, the reason why its mortality parallels its incidence. Within the last decade, the treatment hasn’t improved and remains limited because of the excessive amount of mutations involved in its pathogeny.
Methods
Through a retrospective study carried out during 7 years, going from 2012 to 2019 at the medical oncology department of the Mohammed VI University Hospital-Marrakech, we describe the epidemiological factors, the clinical characteristics as well as the therapeutic outcomes of Pancreatic cancer.
Results
Overall, 142 patients were included, median age at diagnosis was 57.54 years with a sex ratio of 1.29. 29.6% of our patients had diabetes, 26.1% were smokers and alcohol consumption was noted in 9.2%. A family history was reported by 15 patients (10.6%). 71% of our patients had a PS (1-2) and most common symptoms were the deterioration of general condition (64.1%), epigastric pain (62.6%) and jaundice (52.8%). 96.5% of our patients had a ductal adenocarcinoma and 71.1% of tumors were located in the head of pancreas. 61% of our patients were diagnosed at a stage IV and the main site of metastasis was liver (49.3%). 21.1% of our patients had curative surgery while 31% had palliative surgery. 14.2% of our patients had an adjuvant chemotherapy, 70% received Gemcitabine monotherapy, 20% Gemcitabine-Capecitabine and 10% GEMOX. 60 of our patients with metastatic or unresectable tumors were unfit to chemotherapy and received best supportive care while 56 received a palliative chemotherapy; 55% received Gemcitabine monotherapy, 34% GEMOX, 5% Gemcitabine-Capecitabine and 6% received a 5FU based first-line chemotherapy(FOLFIRINOX, FOLFOX). 17.85% received 2nd line chemotherapy after disease progression. Chemotherapy was generally well tolerated; our patients had mostly digestive toxicities (21%) while 12% had hematologic toxicities especially with combined chemotherapy regimen. Median overall survival was 9.04 months.
Conclusions
Our patients exhibited parallel outcomes compared to literature data. Pancreatic cancer continues to be an unsolved health problem. More investments are required to develop further therapeutic pathways to better face this lethal disease.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
