Variation in Precursor Lesions of Pancreatic Cancer among High-Risk Groups

Pancreatic ductal adenocarcinoma (PDAC) surveillance programs are currently offered to high-risk individuals aiming to detect precursor lesions or PDAC at an early stage. We assessed differences in frequency and behavior of precursor lesions and PDAC between two high-risk groups. Individuals with a...

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Bibliographic Details
Published in:Clinical cancer research 2013-01, Vol.19 (2), p.442-449
Main Authors: POTJER, Thomas P, SCHOT, Ingrid, BARGELLO, Mathias, GRESS, Thomas M, VASEN, Hans F. A, BARTSCH, Detlef K, LANGER, Peter, HEVERHAGEN, Johannes T, WASSER, Martin N. J. M, SLATER, Emily P, KLÖPPEL, Gunter, MORREAU, Hans M, BONSING, Bert A, DE VOS TOT NEDERVEEN CAPPEL, Wouter H
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic agents
Biological and medical sciences
Carcinoma - diagnosis
Carcinoma - pathology
Carcinoma, Pancreatic Ductal - diagnosis
Carcinoma, Pancreatic Ductal - pathology
Cohort Studies
Early Detection of Cancer
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neoplasm Grading
Neoplasm Staging
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - pathology
Pharmacology. Drug treatments
Registries
Tumors
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Summary:Pancreatic ductal adenocarcinoma (PDAC) surveillance programs are currently offered to high-risk individuals aiming to detect precursor lesions or PDAC at an early stage. We assessed differences in frequency and behavior of precursor lesions and PDAC between two high-risk groups. Individuals with a p16-Leiden germline mutation (N = 116; median age 54 years) and individuals from familial pancreatic cancer (FPC) families (N = 125; median age 47 years) were offered annual surveillance by MRI and magnetic resonance cholangiopancreatography (MRCP) with or without endoscopic ultrasound (EUS) for a median surveillance period of 34 months (0-127 months) or 36 months (0-110 months), respectively. Detailed information was collected on pancreatic cystic lesions detected on MRCP and precursor lesions in surgical specimens of patients who underwent pancreatic surgery. Cystic lesions were more common in the FPC cohort (42% vs. 16% in p16-Leiden cohort), whereas PDAC was more common in the p16-Leiden cohort (7% vs. 0.8% in FPC cohort). Intraductal papillary mucinous neoplasm (IPMN) was a common finding in surgical specimens of FPC-individuals, and was only found in two patients of the p16-Leiden cohort. In the p16-Leiden cohort, a substantial proportion of cystic lesions showed growth or malignant transformation during follow-up, whereas in FPC individuals most cystic lesions remain stable. In p16-Leiden mutation carriers, cystic lesions have a higher malignant potential than in FPC-individuals. On the basis of these findings, a more intensive surveillance program may be considered in this high-risk group.
ISSN:1078-0432
1557-3265
DOI:10.1158/1078-0432.ccr-12-2730