Patients’ characteristics and predictors of resectability among patients with pancreatic masses at Muhimbili National Hospital

Abstract

Background: Pancreatic masses are challenging to diagnose and treat due to their indolent course. Despite presence of both curative and palliative surgical services at MNH, there is paucity of data on how these patients are investigated, managed and what predicts a diagnosis of resectable disease. This study will enable clinicians to improve index of suspicion for pancreatic mass and improve on timely diagnosis to capture resectable disease for better outcomes. The aim of this study was to document patients’ characteristics, investigations and predictors of resectability among patients with pancreatic masses at MNH. Materials and Methods: A retrospective analytical study was conducted at MNH involving patients treated between 2018 and 2019 for pancreatic mass. Patients were identified from hospital records and their case notes extracted. Patient demographics, disease characteristics, and management was recorded and analyzed by SPSS. Association between categorical variables was tested by using chi-squared and fisher’s exact tests with a p-value less than 0.005 accepted for significance. Results: 147 patients were included in the study with a mean age of 60.1±13.6 (27 – 89) years with a male to female ratio of 1:1.16. Only 72.1% patients were diagnosed by an abdominal CT scan with only 32.7% with a histological diagnosis. Most patients presented with unresectable (20.2%) and Metastatic (57.3%) disease. The potentially resectable masses were 13.7% with a resection rate of 6%. Young age, residency within Dar es Salaam and employment were associated with diagnosis of a resectable disease. Conclusion: Resection rates of pancreatic masses in our setting is low. Benign pancreatic masses are not uncommon Young age, urban residence and employment status were associated with resectable pancreatic masses. Recommendations: Clinicians should attempt to capture pancreatic masses in early resectable stages so as to increase chances of curative resection.