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

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Abstract

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.

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Authors and Affiliations

  1. Unidad de Epidemiología Clínica y Molecular del Cáncer. Instituto Municipal de Investigación Médica, Universidad Autónoma de Barcelona, Carrer del Dr. Aiguader, 80, 08003, Barcelona, Spain

    Miquel Porta, Xavier Fabregat, Núria Malats, Laura Ruiz, Manuel Jariod, Sergi Costafreda, Juan Alguacil, Josep M. Corominas, Ricard Solà & Francisco X. Real

  2. Departamento de Oncología, Hospital del Mar, Barcelona, Spain

    Xavier Fabregat

  3. Departamento de Gastroenterología, Hospital Vall d’Hebron, Barcelona, Spain

    Luisa Guarner

  4. Departamento de Oncología, Hospital Universitario de Elche. Universidad Miguel Hernández, Alicante, Spain

    Alfredo Carrato & Ana de Miguel

  5. Departamento de Gastroenterología, Hospital del Mar, Barcelona, Spain

    Susana Coll & Ricard Solà

  6. Departamento de Patología, Hospital del Mar, Barcelona, Spain

    Josep M. Corominas

  7. Departamento de Patología, Hospital Mútua de Terrassa, Terrassa. Barcelona, Spain

    Antonio Salas

  8. Universidad Pompeu Fabra, Barcelona, Spain

    Francisco X. Real

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  1. Miquel Porta
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  2. Xavier Fabregat
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  3. Núria Malats
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  4. Luisa Guarner
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  5. Alfredo Carrato
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  6. Ana de Miguel
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  7. Laura Ruiz
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  8. Manuel Jariod
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  9. Sergi Costafreda
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  10. Susana Coll
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  11. Juan Alguacil
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  12. Josep M. Corominas
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  13. Ricard Solà
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  14. Antonio Salas
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  15. Francisco X. Real
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the PANKRAS II Study Group

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Correspondence to Miquel Porta.

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Members of the Multicentre Prospective Study on the Role of the Kras and other Genetic Alterations in the Diagnosis, Prognosis and Etiology of Pancreatic and Biliary Diseases (PANKRAS II) Study Group are mentioned in previous publications.

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Porta, M., Fabregat, X., Malats, N. et al. Exocrine pancreatic cancer: Symptoms at presentation and their relation to tumour site and stage. Clin Transl Oncol 7, 189–197 (2005). https://doi.org/10.1007/BF02712816

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