High-risk lesions in the remnant pancreas: fate of the remnant pancreas after pancreatic resection for pancreatic cancer and intraductal papillary mucinous neoplasms

Miyasaka, Yoshihiro; Ohtsuka, Takao; Matsuda, Ryota; Mori, Yasuhisa; Nakata, Kohei; Ohuchida, Kenoki; Nakamura, Masafumi

doi:10.1007/s00595-019-01852-3

Cited by 6 publications

(7 citation statements)

References 72 publications

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“…Two potential mechanisms underlying the development of remnant pancreatic cancer after partial pancreatic resection for pancreatic cancer have been proposed. One is the recurrence of the initial pancreatic cancer, and the other is the metachronous development of a new primary cancer 4 . Several studies that compared genetic mutations between the initial and remnant pancreatic lesions supported the presence of both patterns 8,10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…Our indication for surgical resection of remnant pancreatic cancer was the same as for primary pancreatic cancer, and the reasons for non-surgical treatment were metastatic disease of a new primary cancer. 4 Several studies that compared genetic mutations between the initial and remnant pancreatic lesions supported the presence of both patterns. 8,10,11 Because of the aggressive nature of pancreatic cancer, approximately 80% of patients who undergo surgery for pancreatic cancer develop recurrence.…”

Section: Re Sultsmentioning

confidence: 98%

“…Because of early detection and improved multidisciplinary treatments, the prognosis of patients who undergo resection for pancreatic cancer has improved 2,3 . While the number of long‐term survivors after surgery for pancreatic cancer has been increasing, reports of patients who develop metachronous cancer in the remnant pancreas have also increased 4 . The proportion of patients who develop remnant pancreatic cancer after resection of pancreatic cancer has been reported to range from 0.7% to 26.7% 4 .…”

Section: Introductionmentioning

confidence: 99%

“…4 The proportion of patients who develop remnant pancreatic cancer after resection of pancreatic cancer has been reported to range from 0.7% to 26.7%. 4 Notably, some studies focusing on early-stage pancreatic cancer (stage 0-I) patients showed a high incidence of remnant pancreatic cancer. 5,6 However, no study has compared the incidence of remnant pancreatic cancer after resection of early-stage pancreatic cancer with that of advanced-stage pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

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Is remnant pancreatic cancer after pancreatic resection more frequent in early‐stage pancreatic cancer than in advanced‐stage cancer?

Miyasaka

Ohtsuka

Kimura

et al. 2020

Annals of Gastroent Surgery

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Aim As the prognosis of patients who undergo resection for pancreatic cancer has improved, reports of remnant pancreatic cancer after pancreatic cancer resection have been increasing. Previous studies regarding early‐stage pancreatic cancer showed a high incidence of remnant pancreatic cancer in these patients. The aim of this study was to investigate the incidence of remnant pancreatic cancer according to the degree of progression of the initial pancreatic cancer. Methods Patients who underwent partial pancreatic resection for primary pancreatic cancer were retrospectively reviewed and divided into an early‐stage group and an advanced‐stage group according to the stage of the initial cancer. Patient characteristics and long‐term outcomes, including development of remnant pancreatic cancer, were compared between the two groups. Results This study included 321 patients who underwent partial pancreatectomy for pancreatic cancer; 32 patients in the early‐stage group and 289 patients in the advanced‐stage group. Remnant pancreatic cancer developed in 19 patients (5.9%); seven patients (21.9%) in the early‐stage group and 12 patients (4.5%) in the advanced‐stage group. The cumulative incidence of remnant pancreatic cancer according to the Kaplan–Meier method was comparable between the two groups (5‐year cumulative incidence: 20.6% vs 9.9%, early‐stage group vs advanced‐stage group; P = .1827). Conclusion Our results suggested that the potential for developing remnant pancreatic cancer was comparable between the early‐stage and the advanced‐stage groups. Therefore, the incidence of remnant pancreatic cancer may increase along with improved pancreatic cancer treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is remnant pancreatic cancer after pancreatic resection more frequent in early‐stage pancreatic cancer than in advanced‐stage cancer?

Miyasaka

Ohtsuka

Kimura

et al. 2020

Annals of Gastroent Surgery

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“…Moreover, the determination whether PanIN lesions are high-or low-grade is impossible without histopathological examination of resected pancreas specimens. The surveillance of remnant pancreas tissue after resection of high-grade PanIN is also controversial [29,82,176]. The rate of recurrence in the remnant pancreas after resection of high-grade PanIN without invasive carcinoma is 0% [108].…”

Section: Challenges In Diagnosis and Follow-upmentioning

confidence: 99%

Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma

Sagami

Yamao

Nakahodo

et al. 2021

Cancers

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Pancreatic ductal adenocarcinoma (PDAC) arises from precursor lesions, such as pancreatic intra-epithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). The prognosis of high-grade precancerous lesions, including high-grade PanIN and high-grade IPMN, without invasive carcinoma is good, despite the overall poor prognosis of PDAC. High-grade PanIN, as a lesion preceding invasive PDAC, is therefore a primary target for intervention. However, detection of localized high-grade PanIN is difficult when using standard radiological approaches. Therefore, most studies of high-grade PanIN have been conducted using specimens that harbor invasive PDAC. Recently, imaging characteristics of high-grade PanIN have been revealed. Obstruction of the pancreatic duct due to high-grade PanIN may induce a loss of acinar cells replaced by fibrosis and lobular parenchymal atrophy. These changes and additional inflammation around the branch pancreatic ducts (BPDs) result in main pancreatic duct (MPD) stenosis, dilation, retention cysts (BPD dilation), focal pancreatic parenchymal atrophy, and/or hypoechoic changes around the MPD. These indirect imaging findings have become important clues for localized, high-grade PanIN detection. To obtain pre-operative histopathological confirmation of suspected cases, serial pancreatic-juice aspiration cytologic examination is effective. In this review, we outline current knowledge on imaging characteristics of high-grade PanIN.

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Dilatation of the main pancreatic duct of unknown origin: causes and risk factors of pre-malignancy or malignancy

et al. 2023

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High-risk lesions in the remnant pancreas: fate of the remnant pancreas after pancreatic resection for pancreatic cancer and intraductal papillary mucinous neoplasms

Cited by 6 publications

References 72 publications

Is remnant pancreatic cancer after pancreatic resection more frequent in early‐stage pancreatic cancer than in advanced‐stage cancer?

Is remnant pancreatic cancer after pancreatic resection more frequent in early‐stage pancreatic cancer than in advanced‐stage cancer?

Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma

Dilatation of the main pancreatic duct of unknown origin: causes and risk factors of pre-malignancy or malignancy

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