Pancreatic Cancer at the Bouaké University Hospital (C？te d’Ivoire): Diagnostic, Therapeutic, and Prognostic Challenges

Background: Pancreatic cancer (PC) is a malignant disease with a dismal prognosis, and its global incidence is steadily rising. In Sub-Saharan Africa, epidemiological data remain scarce. This study aimed to describe the epidemiological, diagnostic, therapeutic, and survival outcomes of PC at the Bouaké University Hospital Center (CHU) in C？te d’Ivoire. Materials and Methods: This was a retrospective cohort study conducted over a 10-year period (January 2013 to January 2023) in the Department of General and Digestive Surgery at the Bouaké University Hospital. Inclusion required histopathological/cytological confirmation or a robust cluster of bio-clinical and radiological evidence. Staging was determined according to the TNM system (AJCC, 8th edition) based on pre-operative or per-operative findings. Survival analysis evaluated the median survival from the date of initial diagnosis. Results: Thirty cases of PC were compiled over 10 years, accounting for 2.77% of all gastrointestinal tumors (n = 1080). The mean age was 64.6 years, with a slight female predominance (sex ratio = 0.87). Jaundice was the primary reason for admission (86.7%). Abdominal CT scan was performed in 86.7% of cases. The tumor was located in the pancreatic head in 87% of cases. Histopathological confirmation was obtained in 23 patients (77%, all ductal adenocarcinomas), while 7 patients (23%) met presumptive criteria. Advanced stage IV (metastatic) disease predominated (57%, n = 17). Management was surgical in 26 patients (87%), dominated by palliative procedures (65%, n = 17). The remaining 4 non-operated patients received exclusive best supportive care. Early 30-day postoperative morbidity was 77% (n = 20/26), characterized by hemorrhage (47%, n = 12/26). The overall mortality rate during follow-up was 37% (n = 11/30), with an estimated median survival time after diagnosis of 5.3 months. Conclusion: At the Bouaké University Hospital, PC is diagnosed at an advanced stage in elderly patients. Limited access to curative treatments, absence of endoscopic ultrasound (EUS), and late presentation account for the low resectability rates and poor survival.