Predictors and diagnostic strategies for early-stage pancreatic ductal adenocarcinoma: A retrospective study

Hideyo Kimura, Takao Ohtsuka, Taketo Matsunaga, Yusuke Watanabe, Koji Tamura, Noboru Ideno, Teppei Aso, Tetsuyuki Miyazaki, Takashi Osoegawa, Shinichi Aishima, Yoshihiro Miyasaka, Junji Ueda, Yasuhiro Ushijima, Hisato Igarashi, Tetsuhide Ito, Shunichi Takahata, Yoshinao Oda, Kazuhiro Mizumoto, Masao Tanaka

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Objectives: As a strategy to diagnose early-stage pancreatic ductal adenocarcinoma (PDAC) is urgently needed, we aimed to clarify characteristics of early-stage PDAC. Methods: We retrospectively reviewed medical records of 299 consecutive patientswho underwent R0 or R1 surgical resection for PDAC between 1994 and 2013 and compared clinical characteristics between patients with early-stage (stages 0-I by Japanese General Rules for Pancreatic Cancer) and advanced-stage (stages II-IV) disease. Diagnostic processes were also analyzed. Results: Twenty-four patients (8%) had early-stage PDAC (stage 0: 11; stage I: 13). Univariate and multivariate analyses showed that presence or history of intraductal papillary mucinous neoplasm (P < 0.01), history of pancreatitis (P < 0.01), and presence or history of extrapancreatic malignancies (P = 0.01) independently predicted detection of early-stage PDAC. Cytological examination during endoscopic retrograde pancreatography cytology was ~65% sensitive in preoperative diagnosis of early-stage PDAC, whereas other imaging modalitieswere only 29% to 38%sensitive; 9 of 24 early-stage PDACs were diagnosed by endoscopic retrograde pancreatography cytology alone. Conclusions: Endoscopic retrograde pancreatography cytology for patients with intraductal papillary mucinous neoplasm or pancreatitis may help diagnose early-stage PDAC. Surveillance of extrapancreatic malignancies might also provide opportunities to detect early-stage PDAC as a second malignancy.

Original languageEnglish
Pages (from-to)1148-1154
Number of pages7
JournalPancreas
Volume44
Issue number7
DOIs
Publication statusPublished - Oct 1 2015

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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