Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Oncology-Medical

Background and aim: The aim of this work is to assess the pattern of care and treatment results of locally advanced and metastatic pancreatic adenocarcinomas regarding clinicopathological data, different therapeutic modalities given to Egyptian patients presented to the National cancer institute (NCI), Egypt, in the period from 2009 to 2013 and their survival parameters. Patients and methods: This is a retrospective cohort study of patients{u2019} files whom were diagnosed as locally advanced or metastatic pancreatic adenocarcinoma treated and followed up at the Medical oncology department, National cancer institute (NCI) in Egypt, during a 5-year period, from 2009 to 2013. Results: This study included 126 cases of locally advanced or metastatic pancreatic adenocarcinoma. Out of the 126 cases included, the male gender was predominant with 60.3%. The majority of the cases were over the age of 55 (about 53% of cases). About 49% had an ECOG PS 1, while only 1.5% was of PS 4. The reported co-morbidities were 26.2% DM, while only 7.9% were smokers. Regarding the initial presentation, 23 suffered from jaundice, 8 had ascites and 29 reported pain. Most of the patients (56.3%) were inoperable. The liver was the commonest site of metastasis (78.48%). Of the first line chemotherapy, 93% was Gemcitabine-based, with only 1 as Neo-adjuvant. The average number of first line cycles was 1-2 cycles with only 1 patient reaching 8 cycles. Only six patients achieved CR after the first line, while 77.6% had progressive disease. Eight patients went for second line chemotherapy, 3 for third line chemotherapy and only 1 patient went for fourth line chemotherapy

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