Abstract 1: Clinicopathological Profile of Pancreatic Cancer Patients in a Lower Middle-Income Country: A Single Centre Study

Abstract Purpose: Pancreatic cancer remains a significant public health challenge in lower-middle-income countries (LMICs), characterized by late-stage diagnosis and limited access to specialized care leading to poor outcomes. This study aimed to describe the clinicopathological profile of patients diagnosed with adenocarcinoma of the pancreas managed at a tertiary care centre in a LMIC, with a focus on key clinical features, diagnostic patterns, and treatment modalities. Methods: A retrospective study was conducted at a tertiary care unit in Sri Lanka among 308 patients diagnosed with pancreatic cancer from 2018 to 2023. Data on demographic details, clinical history, pathological diagnosis, and treatment approaches were extracted from the clinical database using consecutive sampling. Descriptive statistical methods were employed to summarize patient characteristics. Results: The mean age of the participants was 59.52 years (SD=14.18) and the majority were males (n=155, 50.32%). Majority were non-alcoholic (73.70%) and non-smokers (80.19%). Overall health of majority belonged to ASA II: A patient with mild systemic disease (n=163,52.92%). Median time from symptom discovery to initial treatment was 9.90 weeks. Common presenting symptoms were weight loss (48.24%), loss of appetite (40.46%), abdominal pain (25.68%), and jaundice (24.51%). Most prevalent pathological diagnosis was adenocarcinoma of pancreas (n=144, 46.75%) and majority were located in the pancreatic head (n=103, 73.57%). of the adenocarcinoma of pancreas cases that were pathologically assessed most presented with locally advanced disease (n=44, 37.93%), with T3 stage being the most prevalent (n=25, 21.55%). Surgical resection with curative intent was often limited, with palliative care being the predominant management approach (n=143, 56.29%). Conclusion: The predominance of adenocarcinoma and its localization in the pancreatic head mirrors global data, where pancreatic ductal adenocarcinoma remains the most common subtype. Late-stage presentation, particularly with a long time taken for presentation, is the challenge of early diagnosis, consistent with the asymptomatic nature in early stages. Despite advances in treatment, the limited surgical intervention and reliance on palliative care underline the aggressive nature of the cancer. Enhanced understanding of clinicopathological features may contribute to tailored interventions and better resource allocation in these resource-constrained settings. Citation Format: Malith Nandasena, Maheeka Seneviwickrama, Malaviaarachchige Dinul Nimnaka Rabel, Hasangi Gamage, Aloka Pathirana, Sashini Denagamagei. Clinicopathological Profile of Pancreatic Cancer Patients in a Lower Middle-Income Country: A Single Centre Study [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 1.