Survival features, prognostic factors, and ‎determinants of diagnosis and treatment among ‎Iranian patients with pancreatic cancer, a ‎prospective study

Sheikh, Mahdi and Masoudi, Sahar and MoayyedKazemi*, Ali reza and Zamani, Farhad (2020) Survival features, prognostic factors, and ‎determinants of diagnosis and treatment among ‎Iranian patients with pancreatic cancer, a ‎prospective study. PLoS One ‎.

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Abstract

Objectives: Investigating the survival features, and determinants of treatment and stage ‎at presentation in Iran.‎ Methods: 461 patients with pancreatic ductal adenocarcinoma (PC) were prospectively ‎enrolled from Shariati hospital, Tehran, Iran, between 2011-2018. All patients underwent ‎endoscopic ultrasonography, computed tomography scanning, and physical examination. ‎Validated questionnaire was completed for the participants and all were actively followed ‎on monthly basis.‎ Results: Median survival time was 6.5 months, and 1-, and 5-year survival rates were ‎‎26.2%, and 1.5%. Patients who were older (p<0.001), illiterate (p = 0.004), unmarried (p ‎‎= 0.003), rural inhabitant (p = 0.013), opium user (p = 0.039), and had lower body mass ‎index (BMI) (p = 0.002) had lower overall survival. Tumors located in the head of pancreas ‎were more commonly diagnosed at lower stages (p<0.001). Only 10.4% of patients ‎underwent surgery who were more commonly educated (p<0.001), married (p = 0.005), ‎had a tumor located in the head of pancreas (p = 0.016), and were diagnosed at lower ‎stages (p<0.001). After adjustment for potential confounders and risk factors, rural ‎inhabitance (HR: 1.33 (95% CI: 1.01-1.74)), having more symptoms (HR for each ‎increasing symptom: 1.06 (1.02-1.11)), using opium (HR: 1.51 (1.04-2.20)), having a ‎tumor located in the body of pancreas (HR: 1.33 (1.02-1.75)), and having an advanced ‎tumor stage (HR: 2.07 (1.34-3.19)) remained significantly associated with increased risk of ‎mortality. After the adjusting for potential confounders, we did not find significant ‎relationships between smoking, alcohol intake, and BMI with the risk of death among ‎patients with pancreatic cancer.‎ Conclusions: Iranian patients with PC have very poor long-term survival. Besides tumor's ‎stage and location, socioeconomic disparities could affect the probabilities of receiving ‎treatment and/or survival in these patients. Opium use is an independent risk factor for ‎mortality among PC patients in Iran.‎

Item Type: Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine, Health and Life Sciences > School of Medicine
Depositing User: samira sepahvandy
Date Deposited: 16 Dec 2020 07:08
Last Modified: 16 Dec 2020 07:08
URI: http://eprints.lums.ac.ir/id/eprint/2474

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