Objective: To determine the trends for the management of pancreatic adenocarcinoma between 1980 and 1994 in a hospital-based population.
Methods: Data of patients from the Doubs department and hospitalized for pancreatic adenocarcinoma in the University Hospital of Besançon were analyzed. Two study periods were determined: 1980-1989 and 1990-1994.
Results: One hundred and thirty five cases were diagnosed (77 male, 58 female, mean age 65.6 +/- 12.1 years). Weight loss (62.3%), pain (52.7%) and jaundice (43.3%) were the most frequently reported symptoms. Their proportion and their duration were similar according to the period. Diagnosis of the pancreatic tumor was made by ultrasonography or tomodensitometry in 97.8% patients. Distribution of tumors according to the AJCC staging was unchanged during the study. Pre-operative screening frequently underestimated tumor stage, even in the more recent period. The rate of complete resection (18.5%) did not increase. The 5-year actuarial survival rate (3.05%) remained unchanged. A metastatic spread represented the only independent prognostic factor.
Conclusions: The management and the prognosis of pancreatic adenocarcinoma have not fundamentally changed. Recent imaging techniques should improve staging accuracy. Advances in adjuvant therapies represent a major issue for the future.