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Risk of Developing Pancreatic Cancer in Patients with Chronic Pancreatitis.
Vujasinovic, Miroslav; Dugic, Ana; Maisonneuve, Patrick; Aljic, Amer; Berggren, Robin; Panic, Nikola; Valente, Roberto; Pozzi Mucelli, Raffaella; Waldthaler, Alexander; Ghorbani, Poya; Kordes, Maximilian; Hagström, Hannes; Löhr, Johannes-Matthias.
Afiliação
  • Vujasinovic M; Department of Upper Abdominal Diseases, Karolinska University Hospital, 14186 Stockholm, Sweden.
  • Dugic A; Department of Medicine, Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
  • Maisonneuve P; Department of Medicine, Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
  • Aljic A; Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
  • Berggren R; Department of Medicine, Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
  • Panic N; Department of Medicine, Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
  • Valente R; Department of Upper Abdominal Diseases, Karolinska University Hospital, 14186 Stockholm, Sweden.
  • Pozzi Mucelli R; Department of Medicine, Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
  • Waldthaler A; Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, 14186 Stockholm, Sweden.
  • Ghorbani P; Department of Abdominal Radiology, Karolinska University Hospital, 14186 Stockholm, Sweden.
  • Kordes M; Department of Upper Abdominal Diseases, Karolinska University Hospital, 14186 Stockholm, Sweden.
  • Hagström H; Department of Medicine, Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
  • Löhr JM; Department of Upper Abdominal Diseases, Karolinska University Hospital, 14186 Stockholm, Sweden.
J Clin Med ; 9(11)2020 Nov 19.
Article em En | MEDLINE | ID: mdl-33228173
Background: Patients with chronic pancreatitis (CP) have an increased risk of developing pancreatic ductal adenocarcinoma (PDAC). We present data on PDAC in one of the most extensive European single-centre cohort studies of patients with CP. Methods: Retrospective analysis of prospectively collected data of patients with CP was performed. Aetiology of CP was determined according to the M-ANNHEIM classification system and only patients with definite CP > 18 years at data analysis were included. The final dataset included 581 patients with definite CP diagnosed between 2003 and 2018. Results: At CP diagnosis, there were 371 (63.9%) males and 210 (36.1%) females (median age 57 years, range 2-86). During 3423 person-years of observation, six pancreatic cancers were diagnosed (0.2% year). The mean time between diagnosis of CP and the occurrence of PDAC was 5.0 years (range 2.7-8.6). None of the cancer patients had a family history of PDAC. Diabetes mellitus (DM) was present in five of six (83.3%) patients with PDAC: in three patients before and in two after CP diagnosis. Clinical/laboratory signs of pancreatic exocrine insufficiency (PEI) were present in five of six (83.3%) patients with PDAC: in two at diagnosis of CP and in three after diagnosis. The mean survival time was 4 months after the diagnosis of PDAC (range 0.5-13). PDAC occurred significantly more often (p < 0.001) in two groups of patients without previous acute pancreatitis (AP): 2 of 20 patients (10%) with low body mass index (BMI) and PEI and in 3 of 10 (30%) patients with high BMI and DM at diagnosis of CP. Conclusions: Patients with CP have a high risk of developing PDAC, although risk is low in absolute terms. Our data suggest the possibility of defining subgroups of patients with a particularly elevated risk of PDAC. Such a possibility would open a path to personalised decision making on initiation of PDAC surveillance of patients with no previous episode of AP, (i) with low BMI and PEI, or (ii) elevated BMI and DM.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2020 Tipo de documento: Article