Pancreatic Cancer in Patients With Pancreatic Cystic Lesions: A Prospective Study in 197 Patients

Tada, Minoru; Kawabe, Takao; Arizumi, Masatoshi; Togawa, Osamu; Matsubara, Saburo; Yamamoto, Natsuyo; Nakai, Yosuke; Sasahira, Naoki; Hirano, Keisuke; Tsujino, Takeshi; Tateishi, Keisuke; Isayama, Hiroyuki; Toda, Nobuo; Yoshida, Haruhiko; Omata, Masao

doi:10.1016/j.cgh.2006.07.013

Cited by 194 publications

(128 citation statements)

References 32 publications

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“…The recent report described earlier from Tada et al, however, suggests that there is also risk in observing patients with cystic lesions of the pancreas (14). In that study, 7 of 197 patients with pancreatic cysts developed pancreatic cancer upon follow-up (0.95% per year), a rate 22.5-fold greater than expected (14).…”

Section: Natural History and Treatmentmentioning

confidence: 61%

“…While this can be hard to prove in an inaccessible organ such as the pancreas, it has been well-established in mouse models of PanIN and in humans for both IPMNs and MCNs (4;8-14). For example, 7 of the 197 patients with pancreatic cystic lesions prospectively followed by Tada et al developed a pancreatic malignancy with an observed incidence of pancreatic cancer (0.95% per year) 22.5 times greater than expected (14).…”

Section: Definition Of Precursormentioning

confidence: 99%

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Precursors to Pancreatic Cancer

Hruban

Maitra

Kern

et al. 2007

Gastroenterology Clinics of North America

190

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Infiltrating ductal adenocarcinoma of the pancreas is believed to arise from morphologically distinct non-invasive precursor lesions. These precursors include the intraductal papillary mucinous neoplasm, the mucinous cystic neoplasm, and pancreatic intraepithelial neoplasia. Intraductal papillary mucinous neoplasms are grossly visible mucin-producing epithelial neoplasms that arise in the main pancreatic duct or one of its branches. The cysts of mucinous cystic neoplasms do not communicate with the major pancreatic ducts and these neoplasms are characterized by a distinct ovarian-type stroma. Pancreatic intraepithelial neoplasia is a microscopic lesion. This review focuses on the clinical significance of these three remarkable precursor lesions with emphasis on their clinical manifestations, detection, and treatment.

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Section: Natural History and Treatmentmentioning

confidence: 61%

Section: Definition Of Precursormentioning

confidence: 99%

Precursors to Pancreatic Cancer

Hruban

Maitra

Kern

et al. 2007

Gastroenterology Clinics of North America

190

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“…Patients with more than one risk factor are recommended to carry out further examinations to detect PC. There have been some reports on the development of PC during follow up of cases with branch duct intraductal papillary mucinous neoplasm (IPMN) or pancreatic cysts 15, 16. Additionally, there have been some retrospective studies of PC concomitant with IPMN (Table 2).…”

Section: Risk Factors and Early Diagnosismentioning

confidence: 99%

Early diagnosis of pancreatic cancer: Current trends and concerns

Hanada

Amano

Abe

2017

Annals of Gastroent Surgery

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Early detection of pancreatic cancer (PC) is essential for a better prognosis. Some recent studies have demonstrated that a slight dilatation of the main pancreatic duct (MPD) and small cystic lesions were detected initially in most cases diagnosed at an early stage. Detecting these abnormal findings in cases with high risk factors through an effective screening system including image diagnosis, some biological markers, or familial cancer registrations should contribute to early diagnosis of PC. It has been reported that endoscopic ultrasonography (EUS) is essential for detecting tumors <10 mm with a favorable prognosis. Additionally, EUS‐guided fine‐needle aspiration biopsy is useful for confirming final histological diagnosis. For the diagnosis of stage 0 PC, local irregular stenosis of MPD should be an important initial abnormal sign detected by EUS or magnetic resonance cholangiopancreatography. Cytodiagnosis multiple times using pancreatic juice obtained by endoscopic nasopancreatic drainage should be essential for the final diagnosis. Recently, activities of regional networks between specialist doctors in medical centers and general practitioners for early diagnosis of PC have been reported in Japan. In the future, these activities may play an important role in the early diagnosis of PC.

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“…In the session of clinical question 1, some risk factors were suggested for the development of PC (Table 1). There are a few reports on the development of PC during the follow-up of patients with branch duct intraductal papillary mucinous neoplasms (IPMNs) [7,8] or pancreatic cysts [9]. Uehara et al [7] reported that the 5-year rate of PC development was 6.9 % during follow-up of patients with branch duct IPMNs.…”

Section: Risk Factors For Pcmentioning

confidence: 99%

“…Uehara et al [7] reported that the 5-year rate of PC development was 6.9 % during follow-up of patients with branch duct IPMNs. Tada et al [9] reported that patients with pancreatic cystic lesions were at a high risk of PC, with a standardized incidence rate of 22.5 %. A multicenter study from a working group of the JPS recently reported that PC distinct from branch duct IPMNs developed in seven (2.0 %) of 349 patients during the follow-up period (median 3.7 years) [10].…”

Section: Risk Factors For Pcmentioning

confidence: 99%