Cáncer del páncreas: un acercamiento a la mortalidad en Cuba

Se estudiaron 906 autopsias de casos con cancer de pancreas, como causa basica de muerte, extraidas de la Base de Datos de Autopsias del Centro Nacional del Sistema Automatizado de Registro y Control de Anatomia Patologica, Registro Nacional de Autopsias en Cuba, con el objetivo de demostrar sus caracteristicas generales, causas directas de muerte, evaluacion de los diagnosticos premortem y aspectos evolutivos. Se representaron 40 hospitales de las distintas provincias del pais, entre los que se destacaron los 6 hospitales militares que realizaron autopsias con el 27 por ciento de los casos. Se analizo la situacion que ocupa el cancer de pancreas en el mundo y en Cuba, y se destaco la importancia y la complejidad del diagnostico precoz a fin de lograr supervivencias mayores. Las edades oscilaron de 19 hasta 101 anos, la decada mss representada fue de 65-74 anos con el 25,7 por ciento y aproximadamente una quinta parte fallecen en edades de interes militar. La razon M/F resulto de 1,3. El csncer como tal, la bronconeumonia y el tromboembolismo pulmonar constituyeron las causas directas de muerte mas frecuente. Las discrepancias diagnosticas totales y parciales en causas basicas de muerte fueron 20,1 y 24 por ciento y las totales en causas directas de muerte el 41,8 por ciento. La localizacion mas frecuente se encontro en cabeza seguida de cuerpo y cola. El carcinoma alcanzo el 100 por ciento mientras que el adenocarcinoma el 92 por ciento. Los sitios de metastasis mas frecuentes: ganglios linfaticos, higado, pulmon y peritoneo. Se destaco la utilizacion de las causas multiples de muerte en el estudio del cancer de pancreas y se reafirmo la funcion de la autopsia como el estudio mas completo del enfermo/enfermedad y garantia de calidad en Medicina. We studied a total of 906 necropsies of cases with cancer of pancreas, as a basic death cause, taken from the Database of Necropsies of the National Center of Automated System of the Registry and Control of Pathological Anatomy, National Registry of Necropsies in Cuba, aimed at showing their general aspects, direct causes of death, assessment of pre-mortem diagnoses, and evolutive aspects. There was a representation of forty hospitals of different provinces of the country, among which the 6 military hospitals that performed necropsies stood out with 27 percent of the cases. The situation of pancreas cancer in the world and in Cuba was analysed, and it was stressed the significance and complexity of early diagnosis to achieve greater survivals. Ages fluctuated between 19 and 101 years old. The most represented decade was that of 65-74 years old, accounting for 25.7 percent. Approximately a fifth died at ages of military interest. M/F ratio was 1.3. Cancer as such, bronchopneumonia and pulmonary thromboembolism were the most frequent direct causes of death. The total and partial diagnostic discrepancies in basic causes of death were 20.1 and 24 percent, and the total in direct causes of death accounted for 41.8 percent. The most frequent localization was the head followed by body and cauda. Carcinoma reached 100 percent and adenocarcinoma 92 percent. The most frequent metastasis sites were the lymphatic ganglia, liver, lungs, and peritoneum. The use of multiple causes of death in the study of pancreas cancer was highlighted. The function of necropsy as the most complete study of patient/disease, and the guarantee of quality in Medicine was also confirmed.