Raimundas Karčauskas1, Tadas Urbonas1, Justinas Abugelis2
1Gastroenterology clinic, Kaunas Clinics, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania.
2Lithuanian university of health sciences, Academy of Medicine, Faculty of medicine.
Background: As the world’s population is getting older pancreatic cancer becomes more common with numerous new cases every year. It’s a mortal disease with lesser than 6 percent 5 years survival rate, because primary symptoms only occurs in later cancer stages and it‘s early diagnostic is complicated. There are currently many studies done to increase patients’ survival by evaluating new diagnostic ways and treatment methods.
Aim: To evaluate survival dependence from demographic characteristics, tumor morphology and applied treatment of patients with pancreatic ductal adenocarcinoma in LSMUL KK Gastroenterology clinic.
Methods and materials: Retrospective analysis of 348 case histories was applied in this research. Data analysis was done using IBM SPSS v25 Statistic program. Survival rate dependence from demographic characteristics, tumor morphology and applied treatment was evaluated using Kaplan-Meier method. Results significance was tested using Log Rank (Mantel-Cox) test and considered statistically significant if p<0,05.
Results: Patients with higher tumor cell differentiation grade had a higher survival rate, compared to patients with lower-grade (p<0,001). Patients with bigger primary tumors, dissemination to regional lymph nodes and distant metastases had a lower survival rate (p<0,001). Patients with early cancer stage had higher survival rate (p<0,001). Patients who received surgical treatment doubled their lifespan compared to other treatment methods (p<0,001). Systemic chemotherapy significantly increased patients survival rate compared to the group without treatment
(p<0,001). Chemotherapy by FOLFIRINOX scheme was significantly more effective compared to monotherapy with Gemcitabine (p<0,001).
Conclusions: Patients with non-disseminated pancreatic cancer, better cell differentiation grade and early stage had longer survival. The most effective treatment method was surgical treatment. Chemotherapy significantly improves the survival of patients with disseminated cancer. Chemotherapy by FOLFIRINOX scheme is most effective.
Keywords: Pancreatic cancer, survival rate.