Diagnostic delay does not influence survival of pancreatic cancer patients
| العنوان: | Diagnostic delay does not influence survival of pancreatic cancer patients |
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| المؤلفون: | Giuseppe Nigri, Carlo Capalbo, Benedetta Graglia, Serena Stigliano, Gabriele Capurso, Caterina Stornello, Giuseppe Vanella, Livia Archibugi |
| المصدر: | United European Gastroenterology Journal. 8:81-90 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Oncology, endocrine system, medicine.medical_specialty, Delayed Diagnosis, Time Factors, Pancreatic ductal adenocarcinoma, Jaundice, Pain, Kaplan-Meier Estimate, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Pancreatic cancer, Internal medicine, Weight Loss, medicine, Advanced disease, Humans, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, business.industry, Age Factors, Gastroenterology, Original Articles, Middle Aged, diagnostic delay, pancreatic cancer, risk factors, survival, symptoms, Prognosis, medicine.disease, Pancreatic Neoplasms, Survival Rate, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business, Carcinoma, Pancreatic Ductal |
| الوصف: | BACKGROUND: Most pancreatic ductal adenocarcinoma patients present with advanced disease. Whether it is possible to increase survival by earlier diagnosis is unclear. OBJECTIVE: The purpose of this study was to investigate the association between presenting complaints and risk factors for pancreatic cancer with diagnostic delay, stage and survival. METHODS: This was a single-centre retrospective cohort study. Consecutive patients were interviewed and data on demographics, medical history, risk factors and complaints leading to pancreatic ductal adenocarcinoma diagnosis and disease stage were recorded. Diagnostic delay was considered as time between first complaint and diagnosis. Patients received appropriate treatments and their outcome was recorded in a dedicated database. The Chi-square test for comparison of categorical variables and the Mann–Whitney test for continuous variables were employed with Bonferroni corrections. Correlation between continuous variables was evaluated by means of the Spearman correlation coefficient. Survival analysis was performed with the Kaplan–Meier method and a log-rank test. RESULTS: The median diagnostic delay for 477 pancreatic ductal adenocarcinoma patients was two months (interquartile range 1–5), being significantly shorter for patients presenting with jaundice compared with those with pain, weight loss, diabetes (p 25 kg/m(2). The median survival time was seven months. Factors associated with worse survival at the multivariable analysis were older age (hazard ratio 1.02 per year), metastatic disease (hazard ratio 2.12) and pain as presenting complaint (hazard ratio 1.32), while diagnostic delay was not. CONCLUSION: While some complaints are associated with a shorter diagnostic delay and less advanced disease stage, we could not demonstrate that delay is associated with survival, possibly suggesting that prevention rather than early recognition is important to tackle pancreatic cancer lethality. |
| تدمد: | 2050-6414 2050-6406 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::108c33a6e8276223e735939cc2bd7090Test https://doi.org/10.1177/2050640619879004Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....108c33a6e8276223e735939cc2bd7090 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20506414 20506406 |
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