Clinical, laboratory biomarkers and imaging findings of pancreatic adenocarcinoma in Iran

Comparison of different Pancreatic cancer treatments: a three-year retrospective study in the oncology center of Tangier university hospital, Morocco

BACKGROUND

Pancreatic cancer is among the most lethal malignancies, with a 5-year overall survival (OS) of less than 10% for all stages. The present study aims to evaluate the epidemiological and clinical characteristics, as well as the results of different treatments of patients diagnosed and treated between 2019 and 2021 in the Oncology Center of Tangier, University Hospital, Morocco.

METHODS

To compare the evolution of the pancreatic cancer between the different chemotherapy regimens, a retrospective study was performed using data collected over a period of 3 years. For each patient, the data were described and statistically analyzed in the dedicated operating sheet.

RESULTS

55 pancreatic cancer patients were included in this study, and the median follow up was 3 months. The mean age of patients was 59.5 ± 10.3 years (extremes 34-79) and the sex ratio male/female was 0.9. Most patients were diagnosed with adenocarcinoma (92.3%), but metastatic stage was the most frequent (56.4%). The surgery was applied to 16.36% of patients. 10.9% of patients have received adjuvant chemotherapy and 76.4% received palliative chemotherapy. Chemotherapy regimens included mainly Gemcitabine and Folfirinox. The median OS was significantly longer for patients treated with Folfirinox versus Gemcitabine (6 months versus 3 months, p-value < 0.016). The median OS for patients that received Folfirinox and Gemcitabine successively (19.7 months) was significantly longer compared to patients that received a monotherapy with either Folfirinox or Gemcitabine alone (p-value < 0.016).

CONCLUSION

These findings reinforce the use of advanced methods for earlier detection of pancreatic cancer and the development of effective immunotherapies or more targeted therapies.

Epidemiologic and Pathologic Study of Pancreatic Cancer in Hamadan, Iran (2008 to 2018)

PURPOSE

Pancreatic cancer is the seventh leading cause of cancer death in cases. The study was conducted to determine the epidemiologic and pathologic of pancreatic cancer METHODS: A case series study was conducted retrospectively at Beheshti Hospital in Hamadan, Iran. A total of 409 cases that had been diagnosed with pancreatic cancer from 2008 to 2018 were reviewed. The variables included age, gender, occupation, pathological type, location involved, early symptoms, metastasis status, prognosis, and treatments were extracted from the files and recorded in checklist. Data were analyzed by using SPSS/20 software.

RESULTS

Pancreatic cancer has been increasing trend in terms of time (2008-2018). Pancreatic cancer was most common age in the sixth decade of life and is more common in men than women. There was a significant relationship between aging and the incidence of pancreatic cancers (P < 0.05). Most of the subjects were urban (50.4%). The frequencies of smoking, alcohol, and drugs were 34.5, 15.6, and 14.0%, respectively. Also, there was no statistically significant relationship between smoking, alcohol, and drugs and pancreatic cancer (P > 0.05). The frequency of pancreatic cancers included adenocarcinomas (66.7%), unknown (25.2%), mucinous adenocarcinomas (4.2%), and carcinoma (3.9%), respectively.

CONCLUSION

Pancreatic cancer has been increasing trend in terms of time. Pancreatic cancer was most common age in the sixth decade of life and is more common in men than women. The most common type of pancreatic cancer was adenocarcinoma. Diagnosis usually occurs at higher stages. More preventive considerations were found to be beneficial among this population.

Predictors of survival rate in patients with pancreatic cancer: A multi-center analytical study in Iran

BACKGROUND

Pancreatic cancer (PC) is among the deadliest cancers of the gastrointestinal tract worldwide and a growing global health concern.

AIM

This study was aimed to evaluate the survival rate and prognostic factors of survival in patients with PC.

METHODS

In this retrospective cohort study, the records of 556 patients with PC registered in the hospital cancer registration system from September 2007 to September 2020 were evaluated. In this regard, demographic data, tumor characteristics, received treatments, and patients' final status were analyzed. Kaplan-Meier and Cox's regression were used for univariate and multivariate analyses, respectively.

RESULTS

The 5-year survival rate was found to be 4.3%. The median survival time was 12.4 ± 6.6 months. Univariate analysis showed that age, BMI (kg/m2 ), blood transfusions, differentiation, tumor stage, tumor size, number of involved lymph nodes, lymph node ratio (LNR), and type of treatment received were significantly associated with patient survival (p < .05). Multivariate Cox regression indicated that the age ≥60 years [Hazard Ratio (HR) = 1.25, 95% confidence interval (CI) = 1.03-1.49], BMI <18 (kg/m2 ; HR = 1.56, 95% CI = 1.13-2.14), poor differentiation (HR = 2.12, 95% CI = 1.75-2.49), tumor size >2.5 cm (HR = 4.61, 95% CI = 3.30-6.78), metastasis presence (HR = 1.97, 95% CI = 1.49-2.60), more than two involved lymph nodes (HR = 1.52, 95% CI = 1.31-1.77), LNR <0.2 (HR = 0.56, 95% CI = 0.36-0.77), and adjuvant therapy with surgery and chemotherapy (HR = 0.44, 95% CI = 0.28-0.61) are the most important prognostic factors of survival in patients with PC (p < .05).

CONCLUSIONS

This study showed that the survival rate of patients with pancreatic cancer varies based on the characteristics of the tumor and the type of treatment received.

Microbiota Alterations and Their Association with Oncogenomic Changes in Pancreatic Cancer Patients

Pancreatic cancer (PC) is an aggressive disease with a high mortality and poor prognosis. The human microbiome is a key factor in many malignancies, having the ability to alter host metabolism and immune responses and participate in tumorigenesis. Gut microbes have an influence on physiological functions of the healthy pancreas and are themselves controlled by pancreatic secretions. An altered oral microbiota may colonize the pancreas and cause local inflammation by the action of its metabolites, which may lead to carcinogenesis. The mechanisms behind dysbiosis and PC development are not completely clear. Herein, we review the complex interactions between PC tumorigenesis and the microbiota, and especially the question, whether and how an altered microbiota induces oncogenomic changes, or vice versa, whether cancer mutations have an impact on microbiota composition. In addition, the role of the microbiota in drug efficacy in PC chemo- and immunotherapies is discussed. Possible future scenarios are the intentional manipulation of the gut microbiota in combination with therapy or the utilization of microbial profiles for the noninvasive screening and monitoring of PC.

[Cancers of the pancreas at the National Hospital and University Center of Cotonou: epidemiological, diagnostic, therapeutic and prognostic features]

INTRODUCTION

cancer is a major cause of death in the world. The purpose of this study is to evaluate the epidemiological, clinical, therapeutic and prognostic features of cancers of the pancreas (CP) at the National Hospital and University Center of Cotonou.

METHODS

we conducted a cross-sectional descriptive and analytical study with a prospective and retrospective data collection over a period of ten years, from 1 October 2009 to 31 October 2019.

RESULTS

out of 15.102 hospitalizations, we identified 72 cases of CP, reflecting a hospitalization rate of 0.5%. The average age of patients was 59 years. The sex-ratio (H/F) was 1.5. The main reason for consultation was abdominal pain. More than half (51.4%) of patients had metastatic tumor at the time of diagnosis. Histological evidence of adenocarcinoma was only reported in 15.1% of cases. The rate of operable patients was 37.5% while the rate of resectable patients was 2.7%. Palliative chemotherapy was given to 13.9% of patients. The average cost of treatment was 955.882,4 FCFA (23.9 times the Guaranteed Interprofessional Minimum Wage in Benin). Median overall survival was 6 months. Mortality rate was 86.9% (53/61), survival rate at one year was 31.4%, and zero at five years. Palliative surgery (p = 0.021) and chemotherapy (p = 0.023) improved patient survival.

CONCLUSION

cancer of the pancreas, due to its non-specific signs and insidious outcome, is often diagnosed at a late stage. A metastatic tumor and the limited individual and institutional therapeutic possibilities lead to more pejorative prognosis.

Pancreatic Cancer in Iran: an Epidemiological Review

PURPOSE

Pancreatic cancer is the seventh cause of death in men in the world and also is one of the most common malignancies worldwide with poor prognosis. Due to the lack of epidemiological aspects of pancreatic cancer in Iran, this study aimed to investigate the epidemiological aspects of pancreatic cancer in Iran.

METHODS

In February 2019, A search was conducted with the keywords "Pancreatic Neoplasm," "Pancreas Neoplasms," "Cancer of Pancreas," "Pancreas Cancer," "Pancreatic Cancer," "Cancer of the Pancreas," and "Iran" in their title or abstract and MeSH. The databases of Medline, Web of Science, Scopus, SID, IranMedex, and Google Scholar were searched. The title and abstract of the papers were reviewed, and articles that addressed the epidemiological aspects of pancreatic cancer were included; in total, 20 full papers were reviewed.

RESULTS

According to studies, the incidence and mortality rate of pancreatic cancer is steadily increasing with age. Actually, men are more likely to develop this carcinoma than women. Smoking, aging, and lifestyle changes are the most important risk factors for pancreatic cancer in Iran. Due to the lack of initial symptoms or a specific marker for early diagnosis of pancreatic cancer, this cancer is detected lately and therefore low survival rate is observed.

CONCLUSION

Mortality and incidence of pancreatic cancer is increasing in Iran. Pancreatic cancer is more common in men than women. Based on the results of this study, pancreatic cancer depends largely on the lifestyle. Survival of pancreatic cancer is low in untreated patients.

Pancreatic Cancer is Associated with Peripheral Leukocyte Oxidative DNA Damage

Background:

DNA damage accumulation has been linked to the cancer phenotype. The purpose of this study was to compare the levels of DNA base 8-hydroxy-2’-deoxyguanosine (8-OHdG) and C-reactive protein (CRP) inflammatory markers in healthy controls and pancreatic cancer patients from a hospital-based case-control study.

Materials and Methods:

Fifty-five pancreatic cancer patients and 55 healthy controls were enrolled from a pool of patients referred to the Endoscopic Ultrasound (EUS) center. Analysis of DNA content of peripheral blood cells was conducted for 8-OHdG with the 32P-postlabelling assay. Serum CRP levels were measured by high-sensitivity assays and demographic data for comparison were collected from individual medical records.

Results:

The group of cases showed significant increased median (IQR) 8-OHdG DNA adducts/106 nucleotides and CRP compared to the controls (208.8 (138.0-340.8) vs 121.8 (57.7-194.8) RAL value; P<0.001) and (3.5 (1.5-8.6) vs 0.5 (0.2-1.5) mg/L P<0.001). A number of conditional regression models confirmed associations of pancreatic cancer with oxidative DNA damage in peripheral leukocytes.

Conclusions:

Our findings suggest the importance of leukocyte 8-OHdG adducts as an indicator for systemic oxidative DNA damage in pancreatic cancer patients. In addition to increase in the CRP inflammatory marker, this supports the impact of inflammation in the occurrence of pancreatic cancer as well as inflammatory responses during cancer development.

Epidemiologic Data, Tumor Size, Histologic Tumor Type and Grade, Pathologic Staging and Follow Up in Cancers of the Ampullary Region and Head of Pancreas in 311 Whipple Resection Specimens of Pakistani Patients

AIM

To report the histologic findings on Whipple resection specimens and thus determine the extent and spread of carcinomas of ampullary region and head of pancreas in our population.

SETTING

Section of Histopathology, Department of Pathology, Aga Khan University Hospital (AKUH), Karachi, Pakistan.

MATERIALS AND METHODS

A case series of 311 consecutive Whipple resection specimens received between January 1,2003 and December 31, 2014. Specimens processed for histologic sections and representative sections submitted and histologically examined as per established and standard protocols. All relevant tumor parameters including histologic type, histologic grade, pathologic T and N stage and tumor size were assessed. Epidemiologic data were also recorded. All findings were analysed using SPSS 19.0 software.

RESULTS

Ampullary (periampullary) carcinomas were much more common than carcinomas of the head of the pancreas, especially in males, with an average age of 53 years. Mean tumor size was 2.5 cms, over 54% were well differentiated. A large majority were pT2 or pT3 and N0. Carcinomas of pancreatic head were also more common in males, mean age was 55 years, mean tumor size was 3.5 cms, and over 65% were moderately differentiated. The majority were T2 or T3 and pN1. Prognostically, significant statistical correlation was seen with tumor grade and pathologic T and N stage (p values statistically significant). However, tumor size was not statistically significant.

CONCLUSIONS

Ampullary carcinomas are more common compared to pancreatic carcinomas. Majority of ampullary carcinomas were well differentiated while majority of pancreatic carcinomas were moderately differentiated. Large majority of both types of cases were pT2 or T3. Histologic tumor grade and pathologic T and N stage are significantly related to prognosis in Pakistani patients with ampullary and pancreatic cancers.