Analysis of Progression Time in Pancreatic Cancer including Carcinoma In Situ Based on Magnetic Resonance Cholangiopancreatography Findings

Abstract

Background: Pancreatic cancer (PC) exhibits extremely rapid growth; however, it remains largely unknown whether the early stages of PC also exhibit rapid growth speed equivalent to advanced PC. This study aimed to investigate the natural history of early PCs through retrospectively assessing pre-diagnostic images. Methods: We examined the data of nine patients, including three patients with carcinoma in situ (CIS), who had undergone magnetic resonance cholangiopancreatography (MRCP) to detect solitary main pancreatic duct (MPD) stenosis >1 year before definitive PC diagnosis. We retrospectively analyzed the time to diagnosis and first-time tumor detection from the estimated time point of first-time MPD stenosis detection without tumor lesion. Results: The median tumor size at diagnosis and the first-time tumor detection size were 14 and 7.5 mm, respectively. The median time to diagnosis and first-time tumor detection were 26 and 49 months, respectively. Conclusions: No studies have investigated the PC history, especially that of early PCs, including CIS, based on the initial detection of MPD stenosis using MRCP. Assessment of a small number of patients showed that the time to progression can take several years in the early PC stages. Understanding this natural history is very important in the clinical setting.

Current trends in the diagnosis of pancreatic cancer

“…Magnetic resonance (MR) imaging of the pancreas along with MR cholangiopancreatography (MRCP) allow for accurate detection of early PDAC by facilitating morphological analysis of pancreatic ductal changes (64). A recent study found that incipient MPD stenosis on pre--diagnostic MRCP can be detected 26-49 months prior to pancreatic tumor detection on any of the imaging methods (CT, MR, or EUS) (77).…”

“…This is valuable for clinicians as it indicates that EUS can also exclude pancreatic cancer. In patients with PDAC it is frequently used as a complementary staging tool to evaluate regional lymph nodes, define the degree of tumor--vascular involvement, or secure a definitive cytologic or histologic diagnosis (77,83).…”

Elaiophylin Elicits Robust Anti-Tumor Responses via Apoptosis Induction and Attenuation of Proliferation, Migration, Invasion, and Angiogenesis in Pancreatic Cancer Cells

“…Despite substantial efforts in cancer research, the five-year survival rate for pancreatic cancer remains extremely low, at approximately 10%, underscoring the urgent need for novel therapeutic strategies [3]. Pancreatic cancer is characterized by its rapid progression [4], late-stage diagnosis [4], and resistance to conventional therapies [5]. The majority of patients present with advanced disease, precluding curative surgical intervention and rendering systemic therapies less effective [6].…”