Medical Oncology Department, A.C. Camargo Cancer Center, Rua Prof. Antônio Prudente, 211, São Paulo, SP, 01509-010, Brazil.
Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
Sci Rep. 2021 Mar 18;11(1):6346. doi: 10.1038/s41598-021-85759-5.
Little is known about the features and outcomes of Brazilian patients with pancreatic cancer. We sought to describe the socio-economic characteristics, patterns of health care access, and survival of patients diagnosed with malignant pancreatic tumors from 2000 to 2014 in São Paulo, Brazil. We included patients with malignant exocrine and non-classified pancreatic tumors according to the International Classifications of Disease (ICD)-O-2 and -O-3, diagnosed from 2000 to 2014, who were registered in the FOSP database. Prognostic factors for overall survival (OS) in the subgroup of patients with ductal or non-specified (adeno)carcinoma were evaluated using Cox proportional hazard model. The study population consists of 6855 patients. Median time from the first visit to diagnosis and treatment were 13 (Interquartile range [IQR] 4-30) and 24 (IQR 8-55) days, respectively. Both intervals were longer for patients treated in the public setting. Median OS was 4.9 months (95% confidence interval [95% CI] 4.7-5.2). Increasing age, male gender, lower educational level, treatment in the public setting, absence of treatment, advanced stage, and treatment from 2000 to 2004 were associated with inferior OS. From 2000-2004 to 2010-2014, no improvement in OS was seen for patients treated in the public setting. Survival of patients with malignant pancreatic tumors remains dismal. Socioeconomical variables, especially health care funding, are major determinants of survival. Further work is necessary to decrease inequalities in access to medical care for patients with pancreatic cancer in Brazil.
关于巴西胰腺癌患者的特征和结局知之甚少。我们旨在描述 2000 年至 2014 年在巴西圣保罗被诊断患有恶性胰腺肿瘤的患者的社会经济特征、卫生保健获取模式和生存情况。我们根据国际疾病分类（ICD）-O-2 和 -O-3 纳入了患有外分泌恶性和未分类胰腺肿瘤的患者，这些患者在 2000 年至 2014 年间被 FOSP 数据库登记。使用 Cox 比例风险模型评估了导管或非特异性（腺癌）癌亚组患者总生存（OS）的预后因素。该研究人群包括 6855 名患者。从首次就诊到诊断和治疗的中位时间分别为 13 天（四分位距 [IQR] 4-30）和 24 天（IQR 8-55）。在公共机构接受治疗的患者的这两个间隔都较长。中位 OS 为 4.9 个月（95%置信区间 [95%CI] 4.7-5.2）。年龄增长、男性、较低的教育水平、在公共机构接受治疗、未接受治疗、晚期疾病和 2000 年至 2004 年期间治疗与较差的 OS 相关。从 2000-2004 年到 2010-2014 年，在公共机构接受治疗的患者的 OS 没有改善。恶性胰腺肿瘤患者的生存仍然不佳。社会经济变量，特别是卫生保健资金，是生存的主要决定因素。需要进一步努力，以减少巴西胰腺癌患者获得医疗服务的不平等。
