725P - Pathological proof and survival for patients with biliary-tract or pancreatic tumor

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Pancreatic Cancer
Pathology/Molecular Biology
Presenter christophe Desauw
Authors C. Desauw1, F. El Hajbi2, K. Ligier3, A. Duhamel4, F. Richard4, C. Rose2
  • 1Medical Oncology, C.H.U. Claude Huriez, 59037 - Lille/FR
  • 2Hôpital St Vincent De Paul. Service D'onco-hématologie, Université catholique de Lille, 59000 - lille/FR
  • 3Registre Général Des Cancers De Lille Et De Sa Région, Centre de référence régional en cancérologie, 59000 - Lille/FR
  • 4Unité De Biostatistiques, Ea2694, Univ Lille Nord de France, 59000 - Lille/FR

Abstract

As recommended by ESMO, a final pathological diagnosis (PD) has to be obtained before any chemotherapy, radiotherapy or other non-surgical oncological therapy for pancreatic or biliary tract cancer. PD is also required for inclusion in a clinical trial. In practice, it is sometimes difficult to obtain this pathological proof because of difficult access or poor performance status. Treatment decision is then collegial, based on a clinical, radiological and biological suspicion. We studied patient survival based on availability of PD from the cancer registry of Lille and its region (800 000 inh. - North France). We reviewed patients records over 15 years old diagnosed in 2005 or 2008 for a pancreatic or biliary tract cancer (neuroendocrine excluded). The point was made on 01/12/2011. Patients were divided into 5 groups: PD and surgery (PD-Surg), PD and radiotherapy or chemotherapy (PD-RC), PD and untreat (PD-Un), no PD and radiotherapy or chemotherapy (noPD-RC), no PD and untreat (noPD-Un). Observed survival analysis was obtained from Kaplan-Meier method and statistical significance from log-rank test. Males accounted for 45.8% of 260 patients. The average age was 71.8 years (+/- 12.1). 59.6% were diagnosed as pancreas cancer. PD was not obtained in 54.2% (60% in pancreas and 45.7% in biliary tract respectively). Seven patients were lost of follow-up.

PD-Surg PD-RC noPD-RC PD-Un noPD-Un
n (%) 45 (17.3) 44 (16.9%) 37 (14.2%) 30 (11.5%) 104 (40%)
Median survival (days) 709 198 203 76 60
p > 0.2 p > 0.9
2 years survival 46.7% 6.8% 2.9% 0% 2.1%

27 patients were alive beyond 24 month: 21 in PD-Surg group, 3 in PD-RC, 1 in noPD-RC and 2 in noPD-Un. In conclusion, the absence of PD is common in clinical practice, without apparent impact on survival. 14.2% of patient were treated without PD. These patients are not take account in current recommendations. Centralized monitoring of this condition would be required. In the absence of treatment plan, PD is not essential.

Disclosure

All authors have declared no conflicts of interest.