Details

Autor(en) / Beteiligte

• Vasen, Hans
• Ibrahim, Isaura
• Ponce, Carmen Guillen
• Slater, Emily P
• Matthäi, Elvira
• Carrato, Alfredo
• Earl, Julie
• Robbers, Kristin
• van Mil, Anneke M
• Potjer, Thomas
• Bonsing, Bert A
• de Vos Tot Nederveen Cappel, Wouter H
• Bergman, Wilma
• Wasser, Martin
• Morreau, Hans
• Klöppel, Günter
• Schicker, Christoph
• Steinkamp, Martin
• Figiel, Jens
• Esposito, Irene
• Mocci, Evelina
• Vazquez-Sequeiros, Enrique
• Sanjuanbenito, Alfonso
• Muñoz-Beltran, Maria
• Montans, José
• Langer, Peter
• Fendrich, Volker
• Bartsch, Detlef K

Titel

Benefit of Surveillance for Pancreatic Cancer in High-Risk Individuals: Outcome of Long-Term Prospective Follow-Up Studies From Three European Expert Centers

Ist Teil von

• Journal of clinical oncology, 2016-06, Vol.34 (17), p.2010-2019

Ort / Verlag

United States

Erscheinungsjahr

2016

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis. Hereditary factors play a role in the development of PDAC in 3% to 5% of all patients. Surveillance of high-risk groups, may facilitate detection of PDAC at an early stage. The aim of this study was to assess whether surveillance aids detection of early-stage PDAC or precursor lesions (PRLs) and improves the prognosis. Screening outcomes were collected from three European centers that conduct prospective screening in high-risk groups including families with clustering of PDAC (familial pancreatic cancer [FPC]) or families with a gene defect that predisposes to PDAC. The surveillance program consisted of annual magnetic resonance imaging, magnetic resonance cholangiopancreatography, and/or endoscopic ultrasound. Four hundred eleven asymptomatic individuals participated in the surveillance programs, including 178 CDKN2A mutation carriers, 214 individuals with FPC, and 19 BRCA1/2 or PALB2 mutation carriers. PDAC was detected in 13 (7.3%) of 178 CDKN2A mutation carriers. The resection rate was 75%, and the 5-year survival rate was 24%. Two CDKN2A mutation carriers (1%) underwent surgical resection for low-risk PRL. Two individuals (0.9%) in the FPC cohort had a pancreatic tumor, including one advanced PDAC and one early grade 2 neuroendocrine tumor. Thirteen individuals with FPC (6.1%) underwent surgical resection for a suspected PRL, but only four (1.9%) had high-risk lesions (ie, high-grade intraductal papillary mucinous neoplasms or grade 3 pancreatic intraepithelial neoplasms). One BRCA2 mutation carrier was found to have PDAC, and another BRCA2 mutation carrier and a PALB2 mutation carrier underwent surgery and were found to have low-risk PRL. No serious complications occurred as consequence of the program. Surveillance of CDNK2A mutation carriers is relatively successful, detecting most PDACs at a resectable stage. The benefit of surveillance in families with FPC is less evident.