Abstract 392P
Background
Due to the absence of screening programmes in pancreato-biliary (PB) tumours, diagnosis of theses malignancies relies on symptom recognition, however, they are heterogeneous and non-specific, resulting on late diagnostic and poor survival.
Methods
We conducted a single-centre retrospective observational study which included all consecutive patients diagnosed with PB tumours between 1/June/22 and 1/June/23. Descriptive analysis is presented, Chi-Square and T-Student are used as appropriate.
Results
86 of 96 patients met the inclusion criteria. Most patients were female 57.0% (n=49); median age was 70.5 years (range 42-91); 51 patients (59.3%) pancreatic, 35 (40.7%) biliary (most intrahepatic cholangiocarcinoma (15; 42.9%)). Majority did not have personal or family history of malignancy (60.5% and 70.9% respectively). Majority were diagnosed after presenting to the emergency department (ED) (48; 55.8%); primary care (PC) (33; 38.4%), incidentally (5; 5.8%); 61.6% metastatic stage. There was a trend towards a higher presentation to ED for patients with pancreatic tumours (62.7%) compared to biliary (45.7%; P = 0.1). The most reported symptoms were pain (38.4% of patients), weight loss (30.2%), jaundice (27.9%), increased transaminases (23.3%), dyspepsia (13; 15.1%), asthenia/anorexia (14.0%) and diarrhoea (9.3%); other (23.3%), no significant differences between pancreatic and biliary tumours. The median time from symptom onset to diagnostic confirmation was 2.0 months (range 0-133.89) for all. For patients diagnosed at the ED it was 1.28 months (same for both PC tumours) but for patients diagnosed through PC, the median time seemed longer for biliary (3.28 months) than for pancreatic (1.97 months; P = 0.2). Diagnosis was confirmed by biopsy (45; 52.3%) or cytology (36; 41.9%); 11.6% of patients (10) required repeated samples.
Conclusions
Most patients are diagnosed at the ED and at advanced stages, highlighting the need for earlier diagnosis. For patients presenting to PC, biliary tumours have the longest time from onset of symptoms to diagnosis. Almost half of patients are still diagnosed with cytology, an ongoing challenge to deliver precision medicine approached.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.