Pancreatic cancer in an Asian population.

BACKGROUND AND OBJECTIVES: Most of the available data on pancreatic cancer are from Western countries. The aim was to characterize pancreatic cancer in Asian patients and to compare it with pancreatic cancer in Caucasians. MATERIALS AND METHODS: Inpatients with histologically proven pancreatic cancer were retrospectively recruited at King Chulalongkorn Memorial Hospital from January 2005 to December 2011. RESULTS: The study enrolled 100 patients (male:female = 55:45, mean age 62.7 ± 12.9 years). The amount of time between symptom onset and disease diagnosis was 59.89 ± 63.12 days. The common presenting symptoms included abdominal pain or discomfort (71%), weight loss (70%), and jaundice (60%). Fifty-three of the 100 patients had stage 4 pancreatic cancer. The most common metastatic organ was the liver (n = 42, 79.25%). The survival rates after 1 and 3 years were 24 and 6%, respectively. The overall median time for survival was 5.1 months (range, 3 days to 62.4 months). According to the multivariate analysis, the staging at the time of diagnosis, serum albumin level, and tumor size were found to independently affect the survival rate. Twenty-two patients underwent endoscopic ultrasound-fine-needle aspiration with the sensitivity rate of 86.4% (19/22). CONCLUSION: Because pancreatic cancer in Asians may be clinically similar to the disease in Caucasians, the goals of future research of the disease may also be similar in the two populations.

Abnormal findings in breast imaging: a hospital-based survey in 4264 Thai women.

OBJECTIVE: To evaluate the distributions of common and significant imaging findings from breast imagings at King Chulalongkorn Memorial Hospitals. MATERIAL AND METHOD: Data was collected from every mammography performed from November 1, 2001 to October 31, 2002. The reports were analyzed and imaging findings were recorded. The ACR BI-RADS category was applied to all cases. RESULTS: There were 4264 patients and all of them were female. The age range was between 19-90 years and average age was 50.1 years. The most common positive findings were cysts (39.22%), followed by focal lesions (14.76%), mass (8.69%), architectural distortion (7.83%), calcification (7.36%) and thick ducts (3.76%). According to ACR BI-RADS, most of the studies were in category 2 (42.59%), followed by category 1 (38.67%), category 3 (12.08%) category 5 (3.45%), category 4 (3.12%) and category 0 (0.09%). CONCLUSION: Breast imaging is the standard screening tool for breast cancer and can reveal different kinds of findings. Knowing the distribution of these findings helps both the radiologists to understand the scope of their work and the institution to audit their practice.

Estrogen and progesterone receptors status in Thai female breast cancer patients: an analysis of 399 cases at King Chulalongkorn Memorial Hospital.

A retrospective review was performed on 576 patients who have been diagnosed breast cancer and referred to Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between January 1995-September 2001. There were three hundred ninety nine cases of invasive breast cancer that available for estrogen (ER) and/or progesterone (PR) receptor status. The mean and median age in our study were 49.6 year and 49.0 year respectively. About 60.9 per cent of the patients were pre and peri-menopause and 37.8 per cent were post-menopause. Most of the histological cell type were invasive ductal carcinoma which comprised of 92.7 per cent. Histologic grading were nearly equal for moderately and poorly differentiated grade: 43.66 per cent and 40.66 per cent. The results of our study showed 53.4 per cent of 399 patients had ER positive and 42.1 per cent of 380 patients had PR positive. The proportion of ER+PR+, ER+PR-, ER-PR+, and ER-PR- were 36.31 per cent, 15.53 per cent, 5.79 per cent and 42.37 per cent respectively. Older age and post-menopause women had higher ER+. While patients with increase tumor size, poorly differentiated grading, increase positivity of axillary lymph nodes and higher stage have more chance of ER negative and PR negative.

Risk factors for symptomatic venous thromboembolism in Thai hospitalised medical patients.

Thromboprophylaxis for venous thromboembolism (VTE) failed to reduce overall mortality in hospitalised medical patients. As a VTE prediction model for Asians is still lacking, this study aimed to identify very high risk patients who would be the main target for prevention. In 2009, medical patients admitted to King Chulalongkorn Memorial hospital, a tertiary care centre, were prospectively evaluated for risk factors. The high-risk cohort was monitored for symptomatic VTE until six weeks after discharge. No heparin prophylaxis was given. Of 1,290 high-risk patients, 27 (2.1%, 95% confidence interval [CI] 1.3-2.9) developed proven VTE, 25.9% of which were diagnosed after discharge. Cases with VTE stayed longer in the hospital (median 18 vs. 11 days, p < 0.001). The significant risk factors in a multivariate analysis were autoimmune disease, solid tumours, family history of VTE, varicose vein and oestrogen with the relative risks of 11.8, 4.7, 120.3, 40.1 and 17.1 (p < 0.001, 0.001, 0.001, 0.002 and 0.038), respectively. Either autoimmune disease or solid tumours were found in 63% of VTE with the relative risk of 4.5 (95% CI 2.1-9.7, p < 0.001). In contrast, previously reported VTE scores in western patients could not stratify the VTE risks, but all the scores predicted higher mortality. In conclusion, VTE is common in Asian hospitalised medical patients. Patients with autoimmune disease and those with solid tumours are highly susceptible to VTE. A prophylactic strategy in these groups is required.