Profile of pancreatic cancers and management characteristics at major hospitals in southeast Nigeria

Abstract

Background: Pancreatic cancer (PC) is emerging as a concern in the global cancer scene. Despite advances in diagnostic and therapeutic  facilities, prognosis has remained poor with almost as many deaths as cases occurring. Availing pertinent information would further  enhance overall understanding of PC and may contribute to early detection and better management.

Objective: To profile PC characteristics in our hospital settings.

Design: Cross-sectional retrospective analysis from January 2013 to December 2021.

Setting: Data on PC from 20 hospitals located in southeast Nigeria.

Subjects: Adult patients with abdominal computed tomography (CT) for anatomical site description and staging of PC or PC diagnosed  during laparotomy.

Intervention: Laparotomy

Main outcome measures: Age, duration in weeks to referrals, diagnostic methods, treatment intervention modalities and mortality  trends.

Results: Of the 178 cases evaluated, 155(87.1%) were presented after six months (late presenters). Reasons for the delay were  financial constraint (30.3%) and late referral (13.5%). Salient clinical observations were; obstructive jaundice (92.1%), ascites (90%) and  gastric outlet obstruction (84.3%). Abdominal CT was used for anatomical site description and staging of PC in 92.3%. Surgical operations performed in 66.3% with 87.3% being bypass and 1.7% pancreatic resection. In all 79.8% were dead within 18 months. Mortality was  raised in delayed presentation(P=0.000), high American Society of Anesthesiologists (ASA) score(P=0.000) and comorbidities(P=0.036).  

Conclusion: This study has shown that management characteristics of PC include consideration of; delayed referrals, clinical  observations, staging and surgical operation. Majority of patients died within 18 months. We recommend findings of this study for  purposeful data mining.