Pancreatic Cancer: Multicenter Prospective Data Collection and Analysis by the Hungarian Pancreatic Study Group
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Gábor Lakatos1, Anita Balázs2, Balázs Kui2, Szilárd Gódi3, Ákos Szücs4, Andrea Szentesi2, Zsolt Szentkereszty5, Richárd Szmola6, Dezső Kelemen7, Róbert Papp7, Áron Vincze3, József Czimmer5, Gabriella Pár3, Judit Bajor3, Imre Szabó3, Ferenc Izbéki8, Adrienn Halász8, László Leindler9, Gyula Farkas Jr.9, Tamás Takács2, László Czakó2, Zoltán Szepes2, Péter Hegyi2,10,11*, Zsuzsanna Kahán12*
1) Dept. Oncology, St. Istvan and St. Laszlo Hospital and Out-Patient Department, Budapest;
2) 1st Dept. Medicine, University of Szeged;
3) 1st Dept. Medicine, University of Pécs;
4) 1st Dept. Surgery, Semmelweis University, Budapest;
5) Institute of Surgery, Clinical Center, University of Debrecen;
6) Dept. Interventional Gastroenterology, National Institute of Oncology, Budapest;
7) Dept. Surgery, University of Pécs;
8) 1st Dept. Medicine, Szent György University Teaching Hospital of County Fejér, Székesfehérvár;
9) Dept. Surgery, University of Szeged;
10) Hungarian Academy of Sciences, University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group;
11) Institute for Translational Medicine & 1st Department of Medicine, University of Pécs;
12) Dept. Oncotherapy, University of Szeged, Hungary
*the last two authors equally contributed to this work
Background & Aims: Pancreatic cancer is a devastating disease with poor prognosis. There is very limited information available regarding the epidemiology and treatment strategies of pancreatic cancer in Central Europe. The purpose of the study was to prospectively collect and analyze data of pancreatic cancer in the Hungarian population.
Methods: The Hungarian Pancreatic Study Group (HPSG) organized prospective, uniform data collection. Altogether 354 patients were enrolled from 14 Hungarian centers.
Results: Chronic pancreatitis was present in 3.7% of the cases, while 33.7% of the patients had diabetes. Family history for pancreatic cancer was positive in 4.8%. The most frequent presenting symptoms included pain (63.8%), weight loss (63%) and jaundice (52.5%). The reported frequency of smoking and alcohol consumption was lower than expected (28.5% and 27.4%, respectively). The majority of patients (75.6%) were diagnosed with advanced disease. Most patients (83.6%) had a primary tumor located in the pancreatic head. The histological diagnosis was ductal adenocarcinoma in 90.7% of the cases, while neuroendocrine tumor was present in 5.3%. Biliary stent implantation was performed in 166 patients, 59.2% of them received metal stents. Primary tumor resection was performed in 60 (16.9%) patients. Enteral or biliary bypass was done in 35 and 49 patients, respectively. In a multivariate Cox-regression model, smoking status and presence of gemcitabine-based chemotherapy were identified as independent predictors for overall survival.
Conclusion: We report the first data from a large cohort of Hungarian pancreatic cancer patients. We identified smoking status and chemotherapy as independent predictors in this cohort.
Key words: pancreatic cancer – Hungarian cohort – acute pancreatitis – chronic pancreatitis – diabetes mellitus.
Abbreviations: EBM: evidence-based medicine; EPI: exocrine pancreatic insufficiency; FNAB: fine needle aspiration biopsy; HPSG: Hungarian Pancreatic Study Group; MDCT: multi-detector computed tomography; OS: overall survival; PC: pancreatic cancer; RPP: Registry for Pancreatic Patients