P-338 Advanced pancreatic adenocarcinoma in daily clinical practice: A single-center experience

Abstract

Results: 49 patients with obstructive jaundice had 76 PTC procedures during the review period. Median patient age was 66 years (range 42 e 90 years). 18 patients (36%) were male and 31 patients (63 %) were female. 20 patients (40 %) had gallbladder and cholangiocarcinoma, 11 patients (22 %) had pancreatic cancer, 8 patients (16 %) had colorectal cancer, 2 had melanoma, 2 had ovarian cancer, 1 had hepatocellular carcinoma, 1 had small bowel cancer, 1 had duodenal cancer, 1 had RCC and 1 had a neuroendocrine tumour. Median time from admission with obstructive jaundice to PTC was 7 days (range 1-42 days). The median duration of hospital stay was 20 days (range 1-65 days). Post PTC 26.5 % patient had further systemic treatment with a median survival of 99 days while 73.5 % of patients had no further treatment, median survival in this sub-group was 44 days. Reasons for no further treatment included frailty in 61 % patients, a decline in performance status post-PTC in 11 %, unsuccessful PTC in 8%, no further treatment available in 5 %, further treatment declined in 3%, stable disease and surveillance in 3% and deaths during the admission in 11% patients. Post PTC, 24% of patients died within 30 days, 32% died between 31-90 days while 44 % of patients survived beyond 90 days. We noticed a 10% complication risk post-PTC with sepsis being the commonest. Re-procedure bilirubin levels did not have any impact on overall survival. Median overall survival post-PTC was 52 days. Conclusion:Obstructive jaundice is a debilitating oncological complication leading to increased patient morbidity and mortality. Fit patients with potential for further treatment should be considered for urgent intervention to improve jaundice, but terminally ill patients with poor performance status and no therapeutic option could be considered for best supportive care.Legal entity responsible for the study: The author.