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[Trends for the management of pancreatic adenocarcinoma in a hospitalized-based population (1980-1994)].

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.