Pancreatic cancer after remote peptic ulcer surgery

Tascilar, Metin; Rees, Bastiaan P. van; Sturm, Patrick; Tytgat, G. N. J.; Hruban, Ralph H.; Goodman, Steven N.; Giardiello, Francis M.; Offerhaus, G. J. A.; Tersmette, A. C.

doi:10.1136/jcp.55.5.340

Cited by 18 publications

(13 citation statements)

References 44 publications

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“…Studies of gastrectomy or peptic ulcer surgery often found positive associations with pancreatic cancer risk. Only three studies considered time between gastrectomy and pancreatic cancer diagnosis, finding increased risk for surgery even with 5-20 yr elapsed [35,40,43]. Interpretation of these results is hampered by the different time frames considered, the inability to adjust for smoking [40,43], and the small numbers of pancreatic cancer patients in these studies.…”

Section: Discussionmentioning

confidence: 99%

Selected medical conditions and risk of pancreatic cancer

Olson

2011

Molecular Carcinogenesis

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We review the current evidence for associations of several medical conditions with risk of pancreatic cancer, including allergies, pancreatitis, gall bladder disease, cholecystectomy, ulcers, gastrectomy, appendectomy, and tonsillectomy. There are consistent findings of reduced risk associated with presence of self-reported allergies, particularly hay fever but not asthma; data on other allergies are limited and inconclusive. Several studies provide evidence that patients with pancreatic cancer are more likely than comparison groups to report pancreatitis. Those studies that investigated the time between onset of pancreatitis and diagnosis of pancreatic cancer found that risk estimates declined with longer periods of time; however, increased risks were noted for long-term pancreatitis, indicating that this condition is both a risk factor and a sign of early disease. Increased risk was reported in association with cholelithiasis, but the few studies that considered time before diagnosis of cancer did not find increased risk for cholelithiasis diagnosed in the more distant past. There is weak evidence that cholecystectomy 2 or more years before cancer diagnosis is related to risk, but this is based on only a few studies. There is no consistent association between ulcers and risk, while gastrectomy may increase risk. Overall, study of these conditions, particularly those that are rare, presents methodologic challenges. Time between diagnoses is likely to be important but is not considered in most studies. Lack of adequate control in several studies for risk factors such as smoking and heavy alcohol use also makes it difficult to draw firm conclusions about these results.

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Section: Discussionmentioning

confidence: 99%

Selected medical conditions and risk of pancreatic cancer

Olson

2011

Molecular Carcinogenesis

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“…Epidemiologic data are mixed regarding the association between peptic ulcer surgery and pancreatic cancer. A cohort study of 2,633 patients who underwent gastrectomy at the University of Amsterdam over a 30-year period reported an overall increased risk for pancreatic cancer of 1.8 (95% CI = 1.3-2.6) [57]. Another large cohort study reported a 4-fold increased risk following gastrectomy, although this risk was detected only after a 20-year latency period [58].…”

Section: Gastric And/or Duodenal Ulcersmentioning

confidence: 97%

Pancreatic cancer and medical history in a population-based case–control study in the San Francisco Bay Area, California

Wang

Holly

2007

Cancer Causes Control

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“…However, upper gastrointestinal carcinoma can involve the pancreas secondarily [2]. Some authors have noted an increase in pancreatic cancer risk after gastric surgery [22]. Therefore, a patient's follow-up after UAS requires the precise assessment of imaging examination on the pancreatic lesions.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic neuroma-like lesions after upper abdominal surgery: a clinicopathological postmortem study

Matsukuma

Sato

2010

Virchows Arch

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To elucidate poorly understood pancreatic neural changes after upper abdominal surgery (UAS), we histologically examined 57 postmortem pancreases after gastrectomy, esophagectomy, and esophageal transection, and also investigated each clinical manifestation. Six pancreases (10.5%) had unique histopathological lesions composed of prominently thickened and/or proliferated neural fascicles. They focally or multifocally involved the pancreatic lobules and/or interlobular septa and mimicked traumatic neuroma. Three of the six lesions were accompanied by moderate to severe chronic pancreatitis/pancreatic fibrosis. All six patients were asymptomatic, although only one exhibited a low-echoic pancreatic mass. There were no statistically significant associations between the pancreatic neural lesions and the patients' sex, age, the time interval between the surgery and the patients' death, impaired glucose tolerance, the presence of hyalinized pancreatic islets, or the presence of moderate to severe chronic pancreatitis/pancreatic fibrosis. No similar prominent neural lesions were identified in an additional 57 age- and sex-matched control pancreases. We concluded that these prominent neural lesions were pancreatic neuroma-like lesions following UAS. This study failed to demonstrate the distinct pathogenesis of the neuroma-like lesions and further investigation may be needed. However, this report is the first to delineate that asymptomatic neuroma-like lesions can occur following UAS. Consideration of this possible development would be useful for accurate follow-up of patients who undergo UAS, although its occurrence may be infrequent.

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Pancreatic cancer after remote peptic ulcer surgery

Cited by 18 publications

References 44 publications

Selected medical conditions and risk of pancreatic cancer

Selected medical conditions and risk of pancreatic cancer

Pancreatic cancer and medical history in a population-based case–control study in the San Francisco Bay Area, California

Pancreatic neuroma-like lesions after upper abdominal surgery: a clinicopathological postmortem study

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