5 research outputs found
Surveillance for pancreatic cancer in high-risk individuals
Background: Surveillance of individuals at high risk of pancreatic ductal adenocarcinoma (PDAC) and its
precursors might lead to better outcomes. The aim of this study was to determine the prevalence
and outcomes of PDAC and high-risk neoplastic precursor lesions among such patients participating
in surveillance programmes.
Methods: A multicentre study was conducted through the International CAncer of the Pancreas Screening (CAPS) Consortium Registry to identify high-risk individuals who had undergone pancreatic resection or progressed to advanced PDAC while under surveillance. High-risk neoplastic precursor lesions
were defined as: pancreatic intraepithelial neoplasia (PanIN) 3, intraductal papillary mucinous neoplasia
(IPMN) with high-grade dysplasia, and pancreatic neuroendocrine tumours at least 2 cm in diameter.
Results: Of 76 high-risk individuals identified in 11 surveillance programmes, 71 had undergone surgery
and five had been diagnosed with inoperable PDAC. Of the 71 patients who underwent resection, 32
(45 per cent) had PDAC or a high-risk precursor (19 PDAC, 4 main-duct IPMN, 4 branch-duct IPMN,
5 PanIN-3); the other 39 patients had lesions thought to be associated with a lower risk of neoplastic
progression. Age at least 65 years, female sex, carriage of a gene mutation and location of a lesion in the
head/uncinate region were associated with high-risk precursor lesions or PDAC. The survival of high-risk
individuals with low-risk neoplastic lesions did not differ from that in those with high-risk precursor
lesions. Survival was worse among patients with PDAC. There was no surgery-related mortality.
Conclusion: A high proportion of high-risk individuals who had surgical resection for screening- or
surveillance-detected pancreatic lesions had a high-risk neoplastic precursor lesion or PDAC