Analysis of Progression Time in Pancreatic Cancer including Carcinoma In Situ Based on Magnetic Resonance Cholangiopancreatography Findings.

Kentaro Yamao,Ken Kamata,Hidekazu Tanaka,Tomohiro Watanabe,Mamoru Takenaka,Tomohiro Yamazaki,Ayana Okamoto,Yasutaka Chiba,Kota Takashima,Akihiro Yoshida,Shunsuke Omoto,Kosuke Minaga,Takaaki Chikugo,Masatoshi Kudo,Masakatsu Tsurusaki

doi:10.3390/diagnostics11101858

Kentaro Yamao, Ken Kamata + Show 13 more

Open Access

https://doi.org/10.3390/diagnostics11101858

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Journal: Diagnostics	Publication Date: Oct 9, 2021
Citations: 4	License type: CC BY 4.0

Affiliation: Kindai University, Kindai University Hospital

Abstract

Background: Pancreatic cancer (PC) exhibits extremely rapid growth; however, it remains largely unknown whether the early stages of PC also exhibit rapid growth speed equivalent to advanced PC. This study aimed to investigate the natural history of early PCs through retrospectively assessing pre-diagnostic images. Methods: We examined the data of nine patients, including three patients with carcinoma in situ (CIS), who had undergone magnetic resonance cholangiopancreatography (MRCP) to detect solitary main pancreatic duct (MPD) stenosis >1 year before definitive PC diagnosis. We retrospectively analyzed the time to diagnosis and first-time tumor detection from the estimated time point of first-time MPD stenosis detection without tumor lesion. Results: The median tumor size at diagnosis and the first-time tumor detection size were 14 and 7.5 mm, respectively. The median time to diagnosis and first-time tumor detection were 26 and 49 months, respectively. Conclusions: No studies have investigated the PC history, especially that of early PCs, including CIS, based on the initial detection of MPD stenosis using MRCP. Assessment of a small number of patients showed that the time to progression can take several years in the early PC stages. Understanding this natural history is very important in the clinical setting.

Highlights

Pancreatic cancer (PC) displays a rapid tumor progression [1,2,3] and has the worst survival rate among the common types of cancer, as shown by the low 3-year survival rate (3%) in unresectable PC cases [4]
We included patients who met all of the following criteria: (i) a diagnosis of PC based on pathological analysis; (ii) magnetic resonance cholangiopancreatography (MRCP) findings indicated solitary main pancreatic duct (MPD) stenosis >1 year before the diagnosis; and (iii) previous history of various imaging (contrast-enhanced computed tomography (CT) (CE-CT) and/or EUS) and follow-up MRCP examinations of pre-existing MPD stenosis
We excluded patients who met any of the following criteria: (i) a diagnosis of intraductal mucinous papillary carcinoma based on pathological analysis; (ii) no detection of MPD stenosis on MRCP; and (iii) a recurrent PC after surgery

Summary

Introduction

Pancreatic cancer (PC) displays a rapid tumor progression [1,2,3] and has the worst survival rate among the common types of cancer, as shown by the low 3-year survival rate (3%) in unresectable PC cases [4]. A few cases have been published in which definite early PC had developed during a long observation period after the initial detection of main pancreatic duct (MPD) stenosis [6,7] These case reports strongly suggested a long-term onset of early PC, estimation of the tumor progression time is very difficult because of the small number of reported patients being diagnosed with early PC. Assessment of a small number of patients showed that the time to progression can take several years in the early PC stages Understanding this natural history is very important in the clinical setting

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