<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902017000300038</article-id>
<article-id pub-id-type="doi">10.29193/rmu.33.3.3</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cáncer de páncreas: epidemiología de su mal pronóstico]]></article-title>
<article-title xml:lang="en"><![CDATA[Pancreatic cancer: epidemiology of a bad prognosis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López Penza]]></surname>
<given-names><![CDATA[Patricia Alejandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruso Martínez]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Maciel Clínica Quirúrgica 3 ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Maciel Clínica Quirúrgica 3 ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<volume>33</volume>
<numero>3</numero>
<fpage>38</fpage>
<lpage>57</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902017000300038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902017000300038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902017000300038&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  el cáncer de páncreas se caracteriza por su agresividad biológica, mal pronóstico oncológico y diagnóstico tardío. La mayoría con baja tasa de resecabilidad (10% a 20%), por la presencia de factores de irresecabilidad al momento del diagnóstico.  Objetivo:  descripción epidemiológica de las características del cáncer de páncreas irresecable, los tratamientos paliativos realizados, la sobrevida global y en relación con los procedimientos realizados.  Material y método:  estudio descriptivo, multivariable, retrospectivo de los cánceres de páncreas irresecables, de enero de 2010 a diciembre de 2015, en la Clínica Quirúrgica 3 del Hospital Maciel.  Resultados:  de los 30 pacientes irresecables: igual distribución por sexo; edad promedio: 61 años, cefálicos en 67% de los casos. El 53% adelgazados al momento de la primera consulta; 52% presentaban compromiso ganglionar locorregional, y 50% presentaba metástasis hepáticas o ascitis. A 52% de los pacientes se les realizó algún tipo de derivación biliar; quirúrgica en 53% (63% coledocoduodenostomías) y el resto percutánea o endoscópica. El 31% de los pacientes, por lo avanzado de la enfermedad, no recibió tratamiento quirúrgico ni endoscópico. La sobrevida media del tratamiento paliativo quirúrgico o endoscópico fue de 3,7 meses.  Conclusiones:  al momento del diagnóstico, la mitad de los casos tenían metástasis y repercusión nutricional severa, con indicadores locorregionales de irresecabilidad o incurabilidad. Un tercio de los casos no recibió tratamiento oncológico por lo avanzado de la enfermedad. La sobrevida global fue escasa. Esto permite sugerir que son imprescindibles medidas sanitarias para su diagnóstico precoz e incremento de la tasa de resecabilidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction: pancreatic cancer is a particularly aggressive cancer with a poor prognosis and it is typically diagnosed at a late stage. Most cases have a lower rate of resectability (10% to 20%) as a result of certain unresectable factors at the time of diagnosis.  Objective:  the study aims to provide an epidemiological description of the characteristics of unresectable pancreatic cancer, palliative treatment, global survival and procedures applied.  Method:  descriptive, multivariable, retrospective study of cases of unresectable cancer from January 2010 to December 2015, at the 3rd Surgical Unit of Hospital Maciel, Montevideo, Uruguay.  Results:  considering the 30 unresectable patients: same sex distribution. Average age was 61 years old, cephalic in 67% of cases. 53 of patients had lost weight at the time of consultation, 52% of them evidenced locoregionallymph node involvement and 50% liver metastases and/or ascites. In 52% of cases some kind of biliary bypass was performed, surgical in 53% (63% pancreaticoduodenectomy), while the rest underwent percutaneous or endoscopic surgery. 31% of patients did not receive surgical or endoscopic treatment given the advanced stage of the condition. Average survival of surgical or endoscopic treatment was 3.7 months.  Conclusions:  at the time of diagnosis, 50% of the cases of pancreatic cancer presented metastases and severe nutritional compromise, evidencing locoregional indicators of unresectability or incurability. One third of the cases did not receive oncological treatment given the advanced stage of the disease. Global survival was low. All of these findings suggest it is essential to devise health policies for an early diagnosis and to increase resec tability rates.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  o câncer de pâncreas se caracteriza por sua agressividade biológica, mal prognóstico oncológico e diagnóstico tardio. A maioria tem baja taxa de ressecabilidade (10% a 20%), devido a presença de fatores específicos que o impedem no momento do diagnóstico.  Objetivo:  descrição epidemiológica das características do câncer de pâncreas irresecable, os tratamentos paliativos realizados, a sobrevida global e em relação aos procedimentos realizados.  Material e método:  estudo descritivo, multivariável, retrospectivo dos cânceres de pâncreas irresecables, atendidos no período janeiro de 2010 a dezembro de 2015, na Clínica Quirúrgica &#8220;3&#8221; do Hospital Maciel em Montevidéu, Uruguai.  Resultados:  os 30 pacientes com câncer de pâncreas irressecáveis apresentavam uma distribuição igual por sexo, idade media: 61 anos, cefálicos em 67% dos casos. 53% dos pacientes haviam emagrecido no momento da primeira consulta; 52% apresentavam compromisso ganglionar locorregional e 50% metástases hepáticas e/ou ascite. 52% dos pacientes foram submetidos a algum tipo de derivação biliar; cirúrgica em 53% (63% coledocoduodenostomias) e nos demais percutânea ou endoscópica. 31% dos pacientes não recebeu tratamento cirúrgico nem endoscópico devido ao estado avançado da doença. A sobrevida media do tratamento paliativo cirúrgico ou endoscópico foi de 3,7 meses.  Conclusões:  no momento do diagnóstico do câncer de pâncreas a metade dos pacientes apresentavam metástases e repercussão nutricional severa, com indicadores locorregionais de irressecabilidade ou incurabilidade. Um terço dos casos não recebeu tratamento oncológico devido ao estado avançado da doença. A sobrevida global foi curta. Isto nos permite sugerir que são imprescindíveis medidas sanitárias para seu diagnóstico precoce e aumento da taxa de ressecabilidade.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[pancreáticas]]></kwd>
<kwd lng="es"><![CDATA[Desviación biliopancreática]]></kwd>
<kwd lng="es"><![CDATA[Stents]]></kwd>
<kwd lng="es"><![CDATA[Cuidados paliativo]]></kwd>
<kwd lng="es"><![CDATA[Pronóstico]]></kwd>
<kwd lng="en"><![CDATA[Pancreatic neoplasms]]></kwd>
<kwd lng="en"><![CDATA[Biliopancreatic diversion]]></kwd>
<kwd lng="en"><![CDATA[Stents]]></kwd>
<kwd lng="en"><![CDATA[Palliative care]]></kwd>
<kwd lng="en"><![CDATA[Prognosis]]></kwd>
<kwd lng="pt"><![CDATA[Neoplasias pancreáticas]]></kwd>
<kwd lng="pt"><![CDATA[Desvio biliopancreático]]></kwd>
<kwd lng="pt"><![CDATA[Stents]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados paliativos]]></kwd>
<kwd lng="pt"><![CDATA[Prognóstico]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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