Management of Metastatic Pancreatic Cancer-Comparison of Global Guidelines over the Last 5 Years.

Pancreatic cancer (PC) is usually diagnosed at an advanced stage of its development, which results in lower overall survival (OS). Prognosis is also poor even with curative-intent surgery. Approximately 80% of patients with localized PDAC have micrometastases at the time of diagnosis, which leads to a worse prognosis than in other cancers. The objective of this study is to present the progress in the treatment of metastatic pancreatic cancer based on the recommendations of oncological scientific societies, such as ESMO, NCCN, ASCO, NICE and SEOM, over the last 5 years. Combined FOLFIRINOX therapy is mostly a recommended therapy among patients with good performance statuses, while gemcitabine is recommended for more fragile patients as a first-line treatment. The newest guidelines suggest that molecular profiling of the tumor should be the first step in determining the course of treatment. The use of modern molecular therapies in patients with specific gene mutations should extend the survival of patients with this disease.

Overview of Pancreatic Cancer Epidemiology in Europe and Recommendations for Screening in High-Risk Populations.

Pancreatic cancer is the seventh most common cause of death in the group of oncological diseases. Due to the asymptomatic course, early diagnosis is difficult. Currently, early detection methods are only used in high-risk groups. A literature review based on the available results of observational studies on patients with pancreatic cancer and people from high-risk groups was used to summarize the knowledge on risk factors. The GLOBOCAN 2020 data were used to assess the epidemiological situation in Europe. A summary of screening recommendations was prepared based on the available documents from medical organizations and associations. Pancreatic cancer risk factors are divided into two main groups: non-modifiable factors, e.g., hereditary factors and age, which increase the risk of developing this disease, and modifiable factors-BMI, smoking, and alcohol consumption. Hereditary factors account for 10% of pancreatic cancer cases. The highly specialized methods of early detection, (MRI, CT, or EUS) are used for screening high-risk populations. Of all the imaging methods, EUS is considered the most sensitive for pancreatic cancer and allows an accurate assessment of the size of even small lesions (<30 mm) and the extent of tumour infiltration into blood vessels. The available studies vary on the level of sensitivity and specificity of these methods for the diagnosis of pancreatic cancer. EUS, MRI, and CT are also expensive procedures and in some patients can be invasive, which is one of the arguments against the introduction of population screening programs based on imaging methods. Therefore, it is important to look for viable solutions that would improve early detection. This is important from the point of view of healthcare systems in Europe, where almost 29% of all global pancreatic cancer cases are reported.

Patient satisfaction with oncological care during the virus pandemic - SARS-CoV-2 taking into account social and demographic factors.

INTRODUCTION AND OBJECTIVE: The aim of the study was to examine the perception of medical services by oncological patients during the pandemic, identifying the key factors influencing it. The assessment of patient satisfaction with the treatment and care provided by doctors and other hospital staff provides important information on the quality of health services. MATERIAL AND METHODS: The study involved 394 patients diagnosed with cancer treated as inpatients in five oncology departments. The diagnostic survey method was used with a proprietary questionnaire and the standardized EORTC IN-PATSAT32 questionnaire. Calculations were carried out using Statistica 10.0 with p≤0.05 s considered statistically significant. RESULTS: Overall patient satisfaction with cancer care was 80.77/100. Higher values were shown for the competences of nurses than for doctors, especially for their interpersonal skills (79.34 - nurses vs. 74.13 - doctors) and availability (80.11 - nurses vs. 75.6 - doctors). It was also shown that the level of satisfaction with cancer care increased with age; women rated cancer care lower than men (p = 0.031), particularly its aspect related to the competences of doctors. A lower degree of satisfaction was observed among rural residents (p=0.042). Other demographic data, such as marital status and education, determined satisfaction with cancer care on the selected scale although it did not affect the overall level of satisfaction. CONCLUSIONS: The analysed socio-demographic factors, primarily age, gender and place of residence, determined some of the scales concerning patient satisfaction with cancer care during the COVID-19 pandemic. The results of this and other studies of a similar profile should be used in the formation of health policy, particularly in implementing programmes to improve the quality of cancer care in Poland.