Introduction:

Pancreatic cancer remains the most lethal cancer in the world due to the low survival rate and poor prognosis. Early diagnosis and planned management are therefore essential to obtain optimal clinical results in these patients. Metabolic conditions such as obesity, Diabetes Mellitus and pancreatic steatosis are also considered as risk factors for pancreatic cancer.

Objective:

Identify associated factors and implications of pancreatic steatosis in patients with ductal pancreatic adenocarcinoma.

Materials and methods:

A retrospective cohort, observational, descriptive and comparative study was conducted of all the endoscopic ultrasounds performed in patients with ductal adenocarcinoma pancreatic tumour in the Gastrointestinal Endoscopy Unit of the National Cancer Institute, during a period between June 2018 and June 2019. The pancreatic cancer diagnosis was performed based on the histology of the biopsy obtained through fine needle aspiration. Electronic clinical history was reviewed in the search of comorbidities (Diabetes Mellitus, Hypertension), the background of pancreatitis, Karnofsky, body mass index, presence of metastasis, tumour staging, lymphatic node number, tumour site determined by endoscopic ultrasound (EUS), tumour size, chemotherapy and surgical treatment recommended. We compare cross tables with a significance level of Pearson Chi-square. Centred research trend measures applied, relative risk, Spearman correlation. The statistical analysis was performed with SPSS version 25 pack. We considered a significant statistic of p=<0.05.

Results:

Out of a total of 30 patients (17 F, 13 M) with an average age of 62 years old. Pancreatic steatosis was diagnosed on 12(40%) patients in the remaining healthy pancreas. About the clinical factors, only Diabetes Mellitus showed an association with pancreatic steatosis (p=0.03). According to the TNM classification, pancreatic steatosis was observed in more advanced clinical stages (p=0.034). Upon involved lymphatic node analysis, it was observed that patients with pancreatic steatosis present greater dissemination compared to patients without pancreatic steatosis (p=0.004). The relative risk estimation was of 13 (2.074-81.4 IC 95%). All patients with ductal pancreatic adenocarcinoma and pancreatic steatosis received first intention palliative chemotherapy (p=0.007).

Conclusion:

The patients with pancreatic steatosis had greater dissemination to lymph nodes and metastasis, consequently more advanced clinical states.