Analysis of diagnostic pathway and therapeutic delay for patients with pancreatic adenocarcinoma: a French retrospective study.

Background: Pancreatic adenocarcinoma (PA) is a growing public health concern and is expected to become the second leading cause of cancer-related death in Europe by 2030. Despite therapeutic advances, prognosis remains poor, with stage at diagnosis the main determinant of outcome, highlighting the need for earlier diagnosis. Objectives: The primary objective was to identify factors associated with the delay between first symptoms and treatment initiation. Secondary objectives included the impact of this delay on tumor stage, progression-free survival (PFS), and overall survival (OS). Design: This study is a single-center retrospective observational cohort. Methods: We retrospectively reviewed medical records of patients with newly diagnosed PA between January 2018 and December 2020 to analyze diagnostic and treatment pathways, delays between first patient-reported symptoms and treatment initiation, and their association with tumor stage, PFS, and OS. Results: A total of 275 consecutive patients were included. The mean time from the first symptom-to-treatment initiation was 120.1 days, significantly shorter in cases of jaundice (82.6 days) and longer for diabetes (179.6 days; Conclusion: The delay between the first symptom and PA treatment initiation remains long, but no survival impact was observed with shorter delays. Symptomatic disease is diagnosed and treated faster, but with no significant impact on survival. These findings underline the need to evaluate new strategies to accelerate PA diagnosis.