Clinical and Translational Oncology

, Volume 7, Issue 5, pp 189–197 | Cite as

Exocrine pancreatic cancer: Symptoms at presentation and their relation to tumour site and stage

  • Miquel PortaEmail author
  • Xavier Fabregat
  • Núria Malats
  • Luisa Guarner
  • Alfredo Carrato
  • Ana de Miguel
  • Laura Ruiz
  • Manuel Jariod
  • Sergi Costafreda
  • Susana Coll
  • Juan Alguacil
  • Josep M. Corominas
  • Ricard Solà
  • Antonio Salas
  • Francisco X. Real
  • the PANKRAS II Study Group
Original Articles


Introduction. The need to detect pancreatic cancer at earlier stages is undisputed. We recorded the signs and symptoms of patients presenting with exocrine pancreatic cancer and evaluated their association with clinical characteristics such as tumour site and disease stage.

Patients and methods. All patients (n=185) with exocrine pancreatic cancer newly diagnosed at five general hospitals in Eastern Spain were prospectively recruited over 3 years. Symptoms were elicited through personal interviews and signs were recorded by the attending physician on admission.

Results. At diagnosis, one third of tumours of the pancreas head were in stage I and another third in stage IV. None of the tumours of the body and tail were in stage I, and over 80% were in stage IV (p<0.001). At presentation, the most frequent symptoms were asthenia (86%), anorexia (83%), weight-loss (85%), abdominal pain (79%), and choluria (59%). Cholestatic symptoms were more common in tumours affecting only the pancreatic head (p<0.001). There was a clear trend towards more localized tumours with increasing numbers of cholestatic signs (p<0.001). Asthenia, anorexia and weight-loss were unrelated to stage. An increased symptom-to-diagnosis interval was associated with more advanced stage (p=0.048).

Conclusions. Proper attention to signs and symptoms, especially cholestasis, may help identify patients with pancreatic cancer at an earlier stage. Results also provide a current picture of the semiology of pancreatic cancer which could be of use in studies on the potential of proteomic tests in the early detection of this neoplasm.

Key words

pancreatic neoplasms/diagnosis pancreatic neoplasms/epidemiology signs and symptoms diagnosis cholestasis jaundice cachexia pruritis pain/diagnosis presentation stage choluria asthenia anorexia weight-loss constitutional syndrome epigastric mass proteomics 


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Copyright information

© FESEO 2005

Authors and Affiliations

  • Miquel Porta
    • 1
    Email author
  • Xavier Fabregat
    • 1
    • 2
  • Núria Malats
    • 1
  • Luisa Guarner
    • 3
  • Alfredo Carrato
    • 4
  • Ana de Miguel
    • 4
  • Laura Ruiz
    • 1
  • Manuel Jariod
    • 1
  • Sergi Costafreda
    • 1
  • Susana Coll
    • 5
  • Juan Alguacil
    • 1
  • Josep M. Corominas
    • 1
    • 6
  • Ricard Solà
    • 1
    • 5
  • Antonio Salas
    • 7
  • Francisco X. Real
    • 1
    • 8
  • the PANKRAS II Study Group
  1. 1.Unidad de Epidemiología Clínica y Molecular del Cáncer. Instituto Municipal de Investigación MédicaUniversidad Autónoma de BarcelonaBarcelonaSpain
  2. 2.Departamento de OncologíaHospital del MarBarcelonaSpain
  3. 3.Departamento de GastroenterologíaHospital Vall d’HebronBarcelonaSpain
  4. 4.Departamento de OncologíaHospital Universitario de Elche. Universidad Miguel HernándezAlicanteSpain
  5. 5.Departamento de GastroenterologíaHospital del MarBarcelonaSpain
  6. 6.Departamento de PatologíaHospital del MarBarcelonaSpain
  7. 7.Departamento de PatologíaHospital Mútua de TerrassaTerrassa. BarcelonaSpain
  8. 8.Universidad Pompeu FabraBarcelonaSpain

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