Abstract
Predictors of Survival in Patients with Pancreatic Cancer in a Tertiary Hospital in the Philippines: A Five-Year Review
John Paul Dela Peña, MD; Pamela Elefante, MD; Hannah Angelica Lacar, MD; Janus Ong, MD
The Medical City
Significance: Pancreatic cancer is a lethal disease with poor outcomes and increased mortality rate. To date, no study has been conducted in the Philippines to evaluate the survival predictors among Filipino patients with pancreatic cancer.
Methodology: This study is a single center hospital-based retrospective cohort which aimed to determine the incidence, clinical profile and predictors of survival among patients with pancreatic cancer seen at The Medical City Hospital from 2018 to 2022. The study design is a hospital-based observational case-control in which cases were retrospectively determined. Raw data was entered into SPSS (IBM) version 23. The Kaplan–Meier with log-rank test was used to compare the distribution of the baseline variables. The Cox regression univariate analysis with p
Results: 200 cases were reviewed. The mean age was 65.1 years (SD = 88 12.1), with 90% aged 50 years and older, with a male- female ratio of 1:2. Most patients presented with advanced and metastatic disease at stage 4 (79%) upon diagnosis. The median survival time was 10 months, while the 1-, 2-, and 3-year survival rate were estimated to be 44%, 26%, and 20% respectively. Based on univariate analysis, patients with normal total bilirubin and without concomitant pulmonary comorbidities, demonstrated a superior survival outcome compared to those with abnormal bilirubin level and those with concomitant pulmonary comorbidities. Meanwhile, Cox multivariate analysis results showed that concomitant pulmonary comorbidity was significantly correlated with the reduced survival rate (HR = 1.87, 95% CI: 1.11 to 18 3.15, p-value = 0.018). An elevated total bilirubin did not significantly correlate with a reduced survival rate (HR = 1.46, 95% CI: 0.96 to 2.20, p-value = 0.075).
Conclusion: Having a concomitant pulmonary comorbidity could increase the vulnerability to pulmonary infection or respiratory failure, which are the leading causes of death in patients with pancreatic cancer. Levels of serum total bilirubin could be a possible predictor of survival among pancreatic cancer patients but further studies are needed to generalize this finding.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |