Predictive Factors for Pancreatic Cancer and Its Early Detection Using Special Pancreatic Ultrasonography in High-Risk Individuals

Abstract

Because pancreatic cancer has a dismal prognosis, a strategy for early diagnosis is required. This study aimed to identify predictive factors of neoplastic progression in patients at high risk for pancreatic cancer and examined the efficiency of surveillance using transabdominal special ultrasonography focusing on the pancreas (special pancreatic US). Patients with slight main pancreatic duct (MPD) dilatation (≥2.5 mm) and/or pancreatic cysts (≥5 mm) were enrolled in a prospective surveillance study with special pancreatic US in a Japanese cancer referral center. A total of 498 patients undergoing surveillance for ≥3 years were included. During the median follow-up of 5.9 years, neoplastic progression developed in 11 patients (2.2%), including 9 patients who underwent pancreatectomy. Eight patients (72.7%) were diagnosed with stage 0/I disease, with an overall survival duration of 8.8 years. Findings of both MPD dilatation and pancreatic cysts at initial surveillance, MPD growth (≥0.2 mm/year) and cyst growth (≥2 mm/year) during surveillance were identified as independent risk factors for neoplastic progression. In summary, surveillance with special pancreatic US for high-risk individuals contributed to earlier detection of neoplastic progression, leading to a favorable prognosis. During surveillance, attention should be paid to MPD growth as well as to cyst growth.

Early detection of venous thromboembolism after the initiation of chemotherapy predicts a poor prognosis in patients with unresectable metastatic pancreatic cancer who underwent first-line chemotherapy with gemcitabine plus nab-paclitaxel

“…Pancreatic cancer is estimated to be the fourth leading cause of death and generally has a poor prognosis, with a 5-year overall survival (OS) rate of 10% at all stages [ 1 ]. Pancreatic cancer is difficult to diagnose at an early stage [ 2 , 3 ], and more than half of patients with pancreatic cancer are diagnosed at unresectable stages [ 4 , 5 ]. Chemotherapy has contributed to improvements in the prognosis of patients with unresectable pancreatic cancer [ 4 – 6 ].…”

Frühdiagnose des Pankreaskarzinoms – Die Rolle von Endosonografie und Sonografie

“…Da ein generelles Pankreaskarzinomscreening der Allgemeinbevölkerung, wie oben angegeben, nicht durchführbar ist, kommt der Abdominalsonografie in diesen Fällen eine herausragende Bedeutung zu. Aus Kostengründen wäre es in individuellen Fällen durchaus zu erwägen, die intensiven Verlaufsuntersuchungen zystischer Pankreasveränderungen intervallmäßig alternierend auch durch abdominalsonografische Kontrolluntersuchungen zu ergänzen [54,55].…”

Main pancreatic duct dilatation and pancreatic cysts in relatives and spouses of patients with pancreatic cancer

“…Special pancreatic ultrasonography demonstrated superiority over conventional transabdominal ultrasonography in detecting pancreatic cysts [ 16 ]. Recently, we found that early detection of PC and favorable prognoses were achieved by surveillance, mainly with special pancreatic ultrasonography, in high-risk individuals with pancreatic cysts and/or dilatation of the main pancreatic duct (MPD) (defined as an MPD diameter of ≥2.5 mm) [ 7 ].…”