Incidentally discovered pancreatic ductal adenocarcinoma: Is detection of asymptomatic cancer associated with better outcomes than symptomatic cancer?

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 243-243
Author(s):  
Yoshinori Takeda ◽  
Akio Saiura ◽  
Yoshihiro Mise ◽  
Takeaki Ishizawa ◽  
Yosuke Inoue ◽  
...  
Keyword(s):  
Early Detection ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Surgical Resection ◽  
Early Stage ◽  
Ductal Adenocarcinoma ◽  
Incomplete Resection ◽  
Long Term Outcomes ◽  
Potential Implication ◽  
Treatment Type

243 Background: The number of incidentally discovered asymptomatic pancreatic ductal adenocarcinoma (APDAC) has been increasing along with recent wide spread use of imaging studies in general practice. However, the clinical implication in early detection of asymptomatic pancreatic cancer remains yet to be determined. In this study, we reviewed our experience of patients with PDAC in high volume cancer center and compared the characteristics and long-term outcomes between those with APDAC and symptomatic PDAC (SPDAC). Methods: This retrospective study included 569 consecutive patients with PDAC initially treated in our institution from January 2007 to December 2012. Median follow-up period was 29 months for the survivors. Two hundred and fifty patients underwent surgical resection and 319 patients were deemed unresectable. The patient’s demographics, tumor locations, pathologic stages, and treatment type received, and the overall survival (OS) were compared between the patients with APDAC and those with SPDAC. Results: One hundred and sixty-three patients (29%) presented without any subjective symptoms. When compared with SPDAC, APDAC was associated with early stage (stage I, 6% vs. 1%, p<0.01). Among 163 patients with APDAC, 104 patients (64%) underwent surgical resection, while only 146 patients (36%) out of 406 SPDAC underwent resection ( p<0.01). The 5-year OS rate of the patients with APDAC was 18%, comparing with 7% for those with SPDAC ( p<0.01). Among the patients who underwent resection, the presence of symptoms did not affect the chance of incomplete resection (R1, 12% vs. 22% for patients with APDAC and SPDAC, respectively, p=0.06) and the 5-year OS rate (23% vs. 22%, p=0.09). However, the patients with SPDAC required complex operation (concomitant vascular resection and reconstruction 56% vs. 29% for those with APDAC, p<0.01). Conclusions: Asymptomatic PDAC is associated with better long-term outcomes than symptomatic PDAC due to early stage at presentation and higher chance of resectability. Our findings highlight the potential implication of screening program for early detection of PDAC for selected high-risk patient population.

scholarly journals MicroRNA-21 Is Induced Early in Pancreatic Ductal Adenocarcinoma Precursor Lesions

2010 ◽  
Vol 56 (4) ◽  
pp. 603-612 ◽  
Author(s):  
Maël Chalret du Rieu ◽  
Jérôme Torrisani ◽  
Janick Selves ◽  
Talal Al Saati ◽  
Anny Souque ◽  
...  
Keyword(s):  
Early Detection ◽  
Mouse Model ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Early Stage ◽  
Survival Rates ◽  
Ductal Adenocarcinoma ◽  
Early Event ◽  
Precursor Lesions ◽  
Tissue Samples ◽  
Ductal Cells

Abstract Background: Pancreatic ductal adenocarcinoma (PDAC) has the poorest overall prognosis among gastrointestinal cancers; however, curative resection in early-stage PDAC greatly improves survival rates, indicating the importance of early detection. Because abnormal microRNA production is commonly detected in cancer, we investigated noninvasive precursor pancreatic intraepithelial neoplasia (PanIN) lesions for microRNA production as a potential early biomarker of PDAC. Methods: Pathologists identified and classified ductal lesions. We extracted total RNA from laser-capture microdissected PanIN tissue samples from a conditional KRAS(G12D) mouse model (n = 29) or of human origin (n = 38) (KRAS is v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog). MicroRNA production was quantified by quantitative real-time PCR. Internal controls included 5S and U6 RNAs. Results: Production of microRNAs miR-21, miR-205, and miR-200 paralleled PanIN progression in the KRAS(G12D) mouse model, compared with microRNA production in samples of nonpathologic ducts. miR-21 demonstrated the highest relative concentrations in the precursor lesions. Interestingly, miR-205 and miR-21 up-regulation preceded phenotypic changes in the ducts. The production of microRNAs miR-21, miR-221, miR-222, and let-7a increased with human PanIN grade, with peak production occurring in hyperplastic PanIN-2/3 lesions. In situ hybridization analysis indicated miR-21 production to be concentrated in pathologic ductal cells. miR-21 production was regulated by KRAS(G12D) and epidermal growth factor receptor in PDAC-derived cell lines. Conclusions: Aberrant microRNA production is an early event in the development of PanIN. Our findings indicate that miR-21 warrants further investigation as a marker for early detection of PDAC.

scholarly journals Short- and long-term outcomes after pancreatectomy for pancreatic ductal adenocarcinoma in octogenarians

Suizo ◽  
2019 ◽  
Vol 34 (5) ◽  
pp. 195-205
Author(s):  
Kensuke NITTA ◽  
Yusuke WATANABE ◽  
Sho OKUDA ◽  
Sho ENDO ◽  
Shingo KOZONO ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Ductal Adenocarcinoma ◽  
Long Term Outcomes ◽  
Short And Long Term

scholarly journals Three-year and five-year outcomes of surgical resection for pancreatic ductal adenocarcinoma: Long-term experiences in one medical center

2018 ◽  
Vol 41 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Chih-Po Hsu ◽  
Jun-Te Hsu ◽  
Chien-Hung Liao ◽  
Shih-Ching Kang ◽  
Being-Chuan Lin ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Surgical Resection ◽  
Medical Center ◽  
Ductal Adenocarcinoma

scholarly journals The Impact of Biomarkers in Pancreatic Ductal Adenocarcinoma on Diagnosis, Surveillance and Therapy

Cancers ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 217
Author(s):  
Niklas Sturm ◽  
Thomas J. Ettrich ◽  
Lukas Perkhofer
Keyword(s):  
Early Detection ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Early Stage ◽  
Therapy Response ◽  
Ductal Adenocarcinoma ◽  
Current State ◽  
Novel Biomarkers ◽  
State Of Research ◽  
Noninvasive Biomarkers ◽  
The Impact

Pancreatic ductal adenocarcinoma (PDAC) is still difficult to treat due to insufficient methods for early diagnosis and prediction of therapy response. Furthermore, surveillance after curatively intended surgery lacks adequate methods for timely detection of recurrence. Therefore, several molecules have been analyzed as predictors of recurrence or early detection of PDAC. Enhanced understanding of molecular tumorigenesis and treatment response triggered the identification of novel biomarkers as predictors for response to conventional chemotherapy or targeted therapy. In conclusion, progress has been made especially in the prediction of therapy response with biomarkers. The use of molecules for early detection and recurrence of PDAC is still at an early stage, but there are promising approaches in noninvasive biomarkers, composite panels and scores that can already ameliorate the current clinical practice. The present review summarizes the current state of research on biomarkers for diagnosis and therapy of pancreatic cancer.

Impact of surgical margin status on long-term outcomes after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

Pancreatology ◽  
2017 ◽  
Vol 17 (5) ◽  
pp. S14
Author(s):  
N. Pelàez ◽  
L. Secanella ◽  
M. Alberich ◽  
J. Busquets ◽  
T. Serrano ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Surgical Margin ◽  
Margin Status ◽  
Ductal Adenocarcinoma ◽  
Long Term Outcomes
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