697P - The relevance of pathological verification in suspected pancreatic cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Pancreatic Cancer
Pathology/Molecular Biology
Presenter Geert-Jan Creemers
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors G. Creemers1, N. Bernards2, C.J. Huysentruyt3, I.H.J.T. De Hingh4, G.P. van der Schelling5, A.P. De Bruïne6, V. Lemmens2
  • 1Department Of Internal Medicine, Catharina Hospital Eindhoven, NL-5602 ZA - Eindhoven/NL
  • 2Dutch Cancer Registry, Comprehensive cancer center Netherlands, 5600AE - Eindhoven/NL
  • 3Department Of Pathology, Eindhoven, The Netherlands, Laboratory for Pathology and Medical Microbiology (PAMM, 5500AA - Veldhoven/NL
  • 4Department Of Surgery, Catharina Hospital Eindhoven, NL-5602 ZA - Eindhoven/NL
  • 5Department Of Surgery, Amphia Hospital, 4800RL - Breda/NL
  • 6Department Of Pathology, Viecuri Medical Centre, 5900BX - Venlo/NL

Abstract

Aim

Patients without pathological verification constitute a significant proportion of the patients with pancreatic cancer, no previous studies described this group of patients in detail. Therefore we assessed which factors were associated with pathological verification, and the clinical relevance.

Methods

All patients diagnosed with a malignancy of the pancreas between 1993 and 2010 in the South of the Netherlands (N = 3,321) were included.

Results

Pancreatic cancer was pathologically verified in 59% of patients. The proportion of verification increased over time from 56% in 1993-1996 to 69% in 2009-2010 (p < 0.0001). High rates of verification were found among young patients (<50 years vs. 60-69 yrs: adjusted odds ratio (ORadj) 3.2, (95%CI:1.9-5.4)), patients with a high socioeconomic status (high vs. low: ORadj 1.3 (95%CI:1.1-1.7)), patients with metastatic disease (metastatic vs locoregional: ORadj 3.2, (95%CI:2.7-3.8)) and patients treated with chemotherapy (yes vs. no: ORadj 2.4, (95%CI:1.8-3.2)).The most favorable prognosis was found in patients with verified locoregional disease (median overall survival (mOS) 7.6 months). Patients with unverified metastatic disease carried the worst prognosis (mOS 1.7 months).

Conclusions

Verification by pathology remains preferable and desirable whenever possible. However, the median survival rates exhibited by patients without verification suggests that the vast majority of patients suffered from true invasive pancreatic cancer. This may justify treatment decisions even in the absence of pathologic verification in selected patients.

Disclosure

All authors have declared no conflicts of interest.