[Paratestikularni žlezni rak - neobičajna oblika zasevka raka trebušne slinavke]

Background. Metastatic paratesticular adenocarcinoma from the pancreatic cancer is very rare. To our knowledge, there are less than 20 cases published in the literature. Case report. We experienced a case of paratesticular adenocarcinoma from the primary pancreatic cancer. A 42-year-old man was presented with locoregionally advanced carcinoma of the tail of the pancreas with intraoperatively found liver metastases and with a tumour in the right hemi-scrotum. Ultrasound of the scrotum revealed a paratesticular tumour. A fine needle aspiration biopsy (FNAB) confirmed a poorly differentiated adenocarcinoma and it was in concordance with the diagnosis of the primary tumour. The patient started treatment with chemotherapy with gemcitabine. Unfortunately, he progressed one month later and the treatment was discontinued. Conclusions. Outcome in the adenocarcinoma of the pancreas is dismal. The only possible treatment option for metastatic disease is systemic therapy but the results are disappointing, as in the present case

Efficacy-effectiveness gap

Randomizirane klinične raziskave (RCT) ter sistematični pregledi in metaanalize, ki temeljijo na RCT, so vir dokazov najvišje kakovosti v medicini. RCT je zunanje veljavna (angl. externally valid), če izsledke iz RCT lahko posplošimo na populacijo bolnikov, ki jo zdravimo v realnem svetu oziroma v vsakodnevnih okoliščinah. Raziskave kažejo, da je preživetje bolnikov z rakom, ki prejemajo sodobna protirakava zdravila v vsakodnevni klinični praksi, pogosto krajše kot preživetje bolnikov, ki so ta ista zdravila prejemali v RCT. Poleg tega je bolnikom v realnem življenjem pogosteje potrebno nižati odmerke zdravil, pogosteje utrpijo resne toksične zaplete in pogosteje so zaradi teh zapletov hospitalizirani kot bolniki v RCT. Populacijske raziskave temeljijo na povezovanju registrov raka z različnimi administrativnimi podatkovnimi bazami. So ključ do kakovostnih podatkov iz vsakodnevnega življenja in so lahko podlaga za izboljšanje zdravstvene oskrbe bolnikov v prihodnosti