Unmet needs in the diagnosis and treatment of Romanian patients with bilio-pancreatic tumors: results of a prospective observational multicentric study.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Romanian Journal of Internal Medicine Pub Date : 2021-08-26 Print Date: 2021-09-01 DOI:10.2478/rjim-2021-0009
Theodor Voiosu, Andrei Voiosu, Cella Danielescu, Daniela Popescu, Claudia Puscasu, Monica State, Aurelia Chiricuţă, Mara Mardare, Andrada Spanu, Andreea Bengus, Bogdan Busuioc, Marius Zamfir, Octav Ginghina, Maria Barbu, Cornelia Nitipir, Bogdan Mateescu
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引用次数: 0

Abstract

Background. Biliopancreatic tumors (BPT) are among the most aggressive solid malignancies, and their incidence is rising. Good patient outcome relies heavily on a multidisciplinary approach to therapy, including timely access to endoscopy, surgery and chemo/radiotherapy. We aimed to evaluate current practices as reflected in the management and outcome of patients diagnosed with BPT in the setting of a low-resource medical system in order to identify areas suitable for improvement. Material and methods. We conducted a prospective observational study of patients with pancreatic cancers and extrahepatic cholangiocarcinomas evaluated in 4 referral centers in Romania. We collected data on the pathology of the tumors, staging at diagnosis, ECOG status, surgical interventions, chemo/radiotherapy and endoscopic drainage where applicable. A telephonic follow-up visit at 3 months after the enrollment visit collected additional data regarding evolution, subsequent treatment, performance status and disease-related events and outcomes. Results and conclusions. One hundred seventy-two patients were included in the study during a one-year period at the four participating centers. 72.1% were diagnosed with pancreatic cancer while 27.9% had extrahepatic cholangiocarcinoma. We identified several unmet needs in the current practices of treatment for these malignancies: a lack of pathological confirmation in 25.6% of the cases, a very low percentage of resectable lesions (only 18% of the patients operated with curative intent), and suboptimal choice of drainage in patients who required palliative drainage at their first endoscopic intervention. Significant effort is required to ensure standard-of-care treatment for patient with BPT in low-resource medical systems, including comprehensive auditing and protocol surveillance.

罗马尼亚胆胰肿瘤患者诊断和治疗中未满足的需求:一项前瞻性观察多中心研究的结果
背景。胆道胰腺肿瘤(BPT)是最具侵袭性的实体恶性肿瘤之一,其发病率正在上升。良好的患者预后在很大程度上依赖于多学科治疗方法,包括及时获得内窥镜检查、手术和化疗/放疗。我们的目的是评估当前在低资源医疗系统中诊断为BPT的患者的管理和结果的实践,以确定适合改进的领域。材料和方法。我们在罗马尼亚的4个转诊中心对胰腺癌和肝外胆管癌患者进行了前瞻性观察研究。我们收集了肿瘤的病理、诊断分期、ECOG状态、手术干预、化疗/放疗和内镜下引流(如适用)的数据。在入组后3个月进行电话随访,收集关于病情发展、后续治疗、表现状况和疾病相关事件和结果的额外数据。结果和结论。在四个参与中心为期一年的研究中,有172名患者参与了这项研究。72.1%诊断为胰腺癌,27.9%诊断为肝外胆管癌。我们确定了目前治疗这些恶性肿瘤的几个未满足的需求:25.6%的病例缺乏病理证实,可切除病变的比例非常低(只有18%的患者进行了治疗目的的手术),在第一次内镜干预时需要姑息性引流的患者中,引流的选择不理想。在资源匮乏的医疗系统中,需要大力确保BPT患者的标准治疗,包括全面的审计和方案监督。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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