Pancreatic Ductal Adenocarcinomas in Long-Term Follow-Up Patients With Branch Duct Intraductal Papillary Mucinous Neoplasms

Tanno, Satoshi; Nakano, Yasuhiro; Koizumi, Kazuya; Sugiyama, Yoshihiko; Nakamura, Kazumasa; Sasajima, Junpei; Nishikawa, Tomoya; Mizukami, Yusuke; Yanagawa, Nobuyuki; Fujii, Tsuneshi; Okumura, Toshikatsu; Obara, Takao; Kohgo, Yutaka

doi:10.1097/mpa.0b013e3181b91cd0

Cited by 157 publications

(83 citation statements)

References 33 publications

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“…Additionally, there have been some retrospective studies of PC concomitant with IPMN (Table 2). 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 These studies demonstrated that the frequency of PC concomitant with IPMN ranged from 1.1% to 11.2%. As for branch duct IPMN, two working groups of JPS reported that seven PC cases were detected in 349 branch duct IPMN cases during the follow‐up period,17 and that PC concomitant with IPMN may be diagnosed earlier than ordinary PC 18.…”

Section: Risk Factors and Early Diagnosismentioning

confidence: 85%

Early diagnosis of pancreatic cancer: Current trends and concerns

Hanada

Amano

Abe

2017

Annals of Gastroent Surgery

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Early detection of pancreatic cancer (PC) is essential for a better prognosis. Some recent studies have demonstrated that a slight dilatation of the main pancreatic duct (MPD) and small cystic lesions were detected initially in most cases diagnosed at an early stage. Detecting these abnormal findings in cases with high risk factors through an effective screening system including image diagnosis, some biological markers, or familial cancer registrations should contribute to early diagnosis of PC. It has been reported that endoscopic ultrasonography (EUS) is essential for detecting tumors <10 mm with a favorable prognosis. Additionally, EUS‐guided fine‐needle aspiration biopsy is useful for confirming final histological diagnosis. For the diagnosis of stage 0 PC, local irregular stenosis of MPD should be an important initial abnormal sign detected by EUS or magnetic resonance cholangiopancreatography. Cytodiagnosis multiple times using pancreatic juice obtained by endoscopic nasopancreatic drainage should be essential for the final diagnosis. Recently, activities of regional networks between specialist doctors in medical centers and general practitioners for early diagnosis of PC have been reported in Japan. In the future, these activities may play an important role in the early diagnosis of PC.

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Section: Risk Factors and Early Diagnosismentioning

confidence: 85%

Early diagnosis of pancreatic cancer: Current trends and concerns

Hanada

Amano

Abe

2017

Annals of Gastroent Surgery

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“…This chapter describes how chronic pancreatitis is suspected, based on signs, symptoms, and laboratory results, and how the diagnosis is developed. The CQ are very detailed and consist of 12 items, including history taking, physical examination, determination methods for pancreatic enzymes in the blood and urine [5,6], significance of various imaging methods [chest and abdominal radiography, abdominal ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound, and pancreatography] in the diagnosis of chronic pancreatitis [7][8][9][10][11][12][13][14][15], exocrine pancreatic function testing, pathological diagnosis, differential diagnosis from pancreatic cancer and intraductal papillary mucinous neoplasm (IPMN), and genetic testing [16][17][18][19][20].…”

Section: Diagnosismentioning

confidence: 99%

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

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Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles. These revised guidelines also refer to early chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009. They include such items as health insurance coverage of high-titer lipase preparations and extracorporeal shock wave lithotripsy, new antidiabetic drugs, and the definition of and treatment approach to pancreatic pseudocyst. The accuracy of these guidelines has been improved by examining and adopting new evidence obtained after the publication of the first edition.

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“…Whereas BD‐IPMN infrequently develop invasive carcinoma, the incidence of PDAC concomitant with BD‐IPMN (4.5‐8.3%) is reportedly higher than that of malignant transformation of BD‐IPMN (0.0‐3.0%)52, 53, 54, 55 (Table 5). Thus, attention should be paid not only to malignant transformation of IPMN itself, but also to the development of concomitant PDAC during surveillance for BD‐IPMN.…”

Section: Surveillance For Ipmn Without Pancreatectomymentioning

confidence: 99%

“…The AGA guidelines suggest that patients without significant changes in their pancreatic cyst for 5 years can discontinue surveillance. However, in their long‐term surveillance of BD‐IPMN without pancreatectomy, Tanno et al55 reported that the 5‐ and 10‐year cumulative incidences of the development of PDAC distinct from BD‐IPMN were 3.0% and 8.8%, respectively. These findings suggest that surveillance of IPMN should be continued for more than 5 years even when the IPMN shows no significant morphological change.…”

Section: Surveillance For Ipmn Without Pancreatectomymentioning

confidence: 99%

Comparison of guidelines for intraductal papillary mucinous neoplasm: What is the next step beyond the current guidelines?

Nakamura

Miyasaka

Sadakari

et al. 2017

Annals of Gastroent Surgery

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Management of intraductal papillary mucinous neoplasm is controversial, and several guidelines have aimed to establish an adequate strategy for surgical resection and surveillance. We compared various intraductal papillary mucinous neoplasm guidelines and considered new matters that are pivotal for improved treatment of intraductal papillary mucinous neoplasm. We identified and compared 11 published guidelines, three of which were major guidelines that mainly referred to the diagnosis and treatment of intraductal papillary mucinous neoplasm (International Association of Pancreatology 2012 guidelines, European Study Group on Cystic Tumours of the Pancreas 2013 guidelines, and American Gastroenterological Association 2015 guidelines). The main concerns of these three guidelines were indication for surgery and follow up of non‐resected lesions. Among the differences between the three guidelines, the period of surveillance recommended was the most controversial matter. Meanwhile, several nomograms have been proposed to improve the diagnosis of intraductal papillary mucinous neoplasm from the level of experts' experiences to that of rational systems. We discuss the adequate strategy of surveillance for intraductal papillary mucinous neoplasm with and without pancreatectomy and nomograms aiming to predict the risk of malignancy in patients with intraductal papillary mucinous neoplasm.

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Pancreatic Ductal Adenocarcinomas in Long-Term Follow-Up Patients With Branch Duct Intraductal Papillary Mucinous Neoplasms

Cited by 157 publications

References 33 publications

Early diagnosis of pancreatic cancer: Current trends and concerns

Early diagnosis of pancreatic cancer: Current trends and concerns

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Comparison of guidelines for intraductal papillary mucinous neoplasm: What is the next step beyond the current guidelines?

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