The Challenges of Managing Malignant Pancreatic Tumors in a Gabonese Hospital Setting

Abstract

Introduction: Pancreatic cancer is one of the most lethal emerging gastrointestinal malignancies. Its management in low-resource settings remains a major challenge. The study aimed to describe the epidemiological, diagnostic, and prognostic characteristics of pancreatic cancer at the University Hospital Center (CHU). Methods: We conducted a retrospective, descriptive cross-sectional study in the Hepatogastroenterology Department of the Libreville University Hospital Center from January 1, 2021, to December 31, 2023. A presumptive diagnosis of pancreatic cancer was established based on Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI) findings. Sociodemographic, diagnostic, and outcome data were collected and analyzed using Epi Info software version 7.6.2.0. Results: The hospital frequency of pancreatic cancer was 1.8% of all hospitalizations and 21.43% of pancreatic diseases. The sex ratio was 1.06, with a mean age of 59 ± 8.87 years. Excessive alcohol consumption (45.45%), diabetes (24.24%), and smoking (21.21%) were the most frequently reported associated exposures. The main clinical manifestations included abdominal pain (93.93%), weight loss (87.87%), asthenia (84.84%), jaundice (69.7%), and a palpable epigastric mass (42.42%). Tumors were predominantly located in the head and body of the pancreas (75.76%), with a mean size of 3.8 cm (±1.5 cm). The mortality rate was 36.36%. Conclusion: Pancreatic cancer was relatively frequent among pancreatic diseases but remained infrequent at the hospital level. It was predominantly diagnosed at an advanced stage, resulting in a poor prognosis. Alcohol consumption and chronic smoking appeared to be the most common associated exposures.