ABSTRACT
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Introduction. The need to detect pancreatic cancerat earlier stages is undisputed. We recorded thesigns and symptoms of patients presenting withexocrine pancreatic cancer and evaluated their associationwith clinical characteristics such as tumoursite and disease stage.Patients and methods. All patients (n = 185) withexocrine pancreatic cancer newly diagnosed at fivegeneral hospitals in Eastern Spain were prospectivelyrecruited over 3 years. Symptoms were elicitedthrough personal interviews and signs were recordedby the attending physician on admission.Results. At diagnosis, one third of tumours of thepancreas head were in stage I and another third instage IV. None of the tumours of the body and tailwere in stage I, and over 80% were in stage IV(p < 0.001). At presentation, the most frequentsymptoms were asthenia (86%), anorexia (83%),weight-loss (85%), abdominal pain (79%), and choluria(59%). Cholestatic symptoms were more commonin tumours affecting only the pancreatic head(p < 0.001). There was a clear trend towards morelocalized tumours with increasing numbers of cholestaticsigns (p < 0.001). Asthenia, anorexia andweight-loss were unrelated to stage. An increased symptom-to-diagnosis interval was associated withmore advanced stage (p = 0.048).Conclusions. Proper attention to signs and symptoms,especially cholestasis, may help identify patientswith pancreatic cancer at an earlier stage. Resultsalso provide a current picture of the semiologyof pancreatic cancer which could be of use in studieson the potential of proteomic tests in the earlydetection of this neoplasm
