Pancreatic Adenocarcinoma Scenario In Brazil: A Clinical-Epidemiological Study Of 4915 Patients

Simone GUARALDI, Instituto Nacional de Cancer, Brazil

1 Molecular Carcinogenesis Program, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
2 Endoscopy Unit, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
3 Clinical Research Division, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
4 Surgical Oncology Division, Instituto Nacional de Cancer, Rio de Janeiro, Brazil

PURPOSE:  The aim of the study was to evaluate the variables associated with adequate response to treatment of pancreatic adenocarcinoma (PA) at the public health system in Brazil.

METHODS:  Data from patients diagnosed as PA registered from 2000 to 2011 were obtained at Integrador system coordinated by Instituto Nacional de Cancer, and from Fundação Oncocentro de São Paulo. Patients without clinical stage information, and with previous cancer or oncological treatment were excluded. Clinical and demographics variables as well as treatment type information were collected. The categorical variables were compared using the chi-square test. Baseline characteristics were included in the univariate logistic regression analysis to identify the association between independent variables and response to treatment with p value <0.05 being considered statistically significant.

RESULTS:  Among 4915 Brazilian patients, those with age <65yo (58.8%), male gender (53.1%), caucasian ethnic background (72.4%), living with a partner (67.5%), level of education >8ys (53.2%), no or former alcohol drinking (73.2%) or former tobacco smoking (57.0%), and clinical stage IV (66.6%) were predominant. They were diagnosed mainly from 2006 to 2011 (64.8%). There was statistical difference on adequate response according to treatment type (p<0.001). After stratifying by clinical stages, this difference was observed on III (p=0.022) and IV (p=0.047) stages. Adequate response was associated with being younger than 65yo (OR=1.24, 95% CI=1:06-1:45, p=0.008) or having more than 8ys of study (OR=1.36, 95% CI=1.13-1.64, p=0.001).

CONCLUSIONS:  The two main sources of registry of Brazilian PA patients present certain discrepancy regarding epidemiological data (alcohol and tobacco smoking prevalence). However, they are useful to demonstrate certain variables impacting treatment response, with patients being generally diagnosed with advanced stage, and patients with <65yo and/or ≥8ys of study presenting a better chance to respond adequately to cancer treatment. 

FUNDING SOURCE:  The study was performed with no public or private funding.