Almost 50% of the patients in the study by Bonneterre et al (2000) had advanced-stage disease at presentation and therefore had received no prior treatment.
Probably, the absence of impact of delay in diagnosis on stage distribution is explained by the indolent nature of disease (significant numbers of ESS present with early-stage disease, even when delay in diagnosis exceeds 24 months; Table 1) and the tendency for transperitoneal spread (asymptomatic spread results in considerable advanced-stage ESS at presentation; Table 1).
Age group remained significant for OS on multivariate analysis, after adjusting for N classification and treatment.Despite more advance stage at presentation, jNPC patients had better survival than did aNPC patients.
Pancreatic adenocarcinoma (PAC) is a very aggressive and lethal cancer, with a very poor prognosis, because of absence of early symptoms, advanced stage at presentation, early metastatic dissemination and lack of both specific tests to detect its growth in the initial phases and effective systemic therapies.
Additionally, advanced stage at presentation is common for these hidden tumours, precluding the use of SNB or indeed any surgical intervention.
Additionally, advanced stage at presentation is common for these hidden tumors, precluding the use of SNB or indeed any surgical intervention.
Thus, there is a positive relationship between increased delay in referral and advanced stage at presentation, significant at the 0.05 level.
These results are in accordance with previous work showing that younger age, advanced stage, emergency presentation and discussion in multidisciplinary meetings were associated with adjuvant chemotherapy use for stage II patients [ 14].
In our previous study conducted on a series of 312 women, we found significantly younger age at onset and advanced stage at presentation among Palestinian Arab (PA) women compared with Israeli Jews [ 2].
The biological abnormalities that are more pronounced in the primary tumor of African Americans, in addition to contributing to early onset, advanced stage of presentation, and aggressive histology, may have important adverse effects on survival.
