Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study
Background Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of s...
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| Veröffentlicht in: | Journal of gastroenterology 2024-12, Vol.59 (12), p.1133-1142 |
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| creator | Miki, Mika Masuda, Atsuhiro Takenaka, Mamoru Shiomi, Hideyuki Iemoto, Takao Tsumura, Hidetaka Tsujimae, Masahiro Toyama, Hirochika Sofue, Keitaro Ueshima, Eisuke Omoto, Shunsuke Yoshida, Akihiro Fukunaga, Tomohiro Tanaka, Hidekazu Nakano, Ryota Ota, Shogo Kobayashi, Takashi Sakai, Arata Kanzawa, Maki Itoh, Tomoo Kodama, Yuzo |
| description | Background
Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of surgical resection. This study aimed to investigate the association of pancreatic atrophy pattern and intraductal cancer extension.
Methods
Thirty-two patients with early-stage pancreatic cancer who underwent surgery at five participating centers were enrolled. Pancreatic atrophy was defined as the narrowing of parenchyma compared to the surrounding parenchyma and was classified as either FPPA (partial atrophy surrounding the pancreatic duct stenosis) or UPA (global atrophy caudal to the site of duct stenosis). Intraductal cancer extension was defined as an extension exceeding 10 mm.
Results
Preoperative computed tomography revealed FPPA, UPA, and no parenchymal atrophy in 13, 13, and 6 patients. Cases with FPPA or UPA showed significantly longer cancer extensions than those without atrophy (
P
= 0.005 and
P
= 0.03, respectively). Intraductal cancer extension was present in all but one case of FPPA. 69% (9/13) of the cases with UPA showed intraductal cancer extension, whereas cases without atrophy showed no intraductal cancer extension. Importantly, two patients with FPPA or UPA showed positive resection margins during surgery and three patients with FPPA or UPA showed recurrence in the remnant pancreas.
Conclusions
The presence of FPPA and UPA indicates lateral cancer extension in early-stage pancreatic cancer. Preoperative assessment of the pancreatic parenchyma may provide valuable insights for determining the extent of surgical resection. |
| doi_str_mv | 10.1007/s00535-024-02149-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11541273</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3106043815</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-fa2512532cd94e0b9b46b4574b734b5a1d7de67fe1b68c3b8d29f06648d0a94c3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EokvhD3BAlrhwCYy_kpgLqiq-pEpc4Gw5zqTrKrEX2yns3-AX47JLKRw4WJZnnnlnxi8hTxm8ZADdqwyghGqAy3qY1A3cIxsma0hpzu-TDWgpG8Y6eUIe5XwFwASo_iE5EZr3QgHfkB9nOUfnbfEx0DjRnQ0uYX06akuKu-2-hkrBFDL95suW-lCSHVdX7Ezxe8GQj5Vo07y_W3-E7IghOpucD3Gxr6mlyzrXPIaqShPWLnmHrvhrpLms4_4xeTDZOeOT431Kvrx7-_n8Q3Px6f3H87OLxkmA0kyWK8aV4G7UEmHQg2wHqTo5dEIOyrKxG7HtJmRD2zsx9CPXE7St7EewWjpxSt4cdHfrsOB4M1Cys9klv9i0N9F683cm-K25jNeGMSUZ70RVeHFUSPHrirmYxWeH82wDxjUbwaAFKXqmKvr8H_QqrinU_SrFpVYaRFspfqBc_ZSccLqdhoG58dwcPDfVc_PLcwO16NndPW5LfptcAXEAck2FS0x_ev9H9idy2Lwa</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3124959036</pqid></control><display><type>article</type><title>Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Miki, Mika ; Masuda, Atsuhiro ; Takenaka, Mamoru ; Shiomi, Hideyuki ; Iemoto, Takao ; Tsumura, Hidetaka ; Tsujimae, Masahiro ; Toyama, Hirochika ; Sofue, Keitaro ; Ueshima, Eisuke ; Omoto, Shunsuke ; Yoshida, Akihiro ; Fukunaga, Tomohiro ; Tanaka, Hidekazu ; Nakano, Ryota ; Ota, Shogo ; Kobayashi, Takashi ; Sakai, Arata ; Kanzawa, Maki ; Itoh, Tomoo ; Kodama, Yuzo</creator><creatorcontrib>Miki, Mika ; Masuda, Atsuhiro ; Takenaka, Mamoru ; Shiomi, Hideyuki ; Iemoto, Takao ; Tsumura, Hidetaka ; Tsujimae, Masahiro ; Toyama, Hirochika ; Sofue, Keitaro ; Ueshima, Eisuke ; Omoto, Shunsuke ; Yoshida, Akihiro ; Fukunaga, Tomohiro ; Tanaka, Hidekazu ; Nakano, Ryota ; Ota, Shogo ; Kobayashi, Takashi ; Sakai, Arata ; Kanzawa, Maki ; Itoh, Tomoo ; Kodama, Yuzo ; SMT Study Group in Japan</creatorcontrib><description>Background
Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of surgical resection. This study aimed to investigate the association of pancreatic atrophy pattern and intraductal cancer extension.
Methods
Thirty-two patients with early-stage pancreatic cancer who underwent surgery at five participating centers were enrolled. Pancreatic atrophy was defined as the narrowing of parenchyma compared to the surrounding parenchyma and was classified as either FPPA (partial atrophy surrounding the pancreatic duct stenosis) or UPA (global atrophy caudal to the site of duct stenosis). Intraductal cancer extension was defined as an extension exceeding 10 mm.
Results
Preoperative computed tomography revealed FPPA, UPA, and no parenchymal atrophy in 13, 13, and 6 patients. Cases with FPPA or UPA showed significantly longer cancer extensions than those without atrophy (
P
= 0.005 and
P
= 0.03, respectively). Intraductal cancer extension was present in all but one case of FPPA. 69% (9/13) of the cases with UPA showed intraductal cancer extension, whereas cases without atrophy showed no intraductal cancer extension. Importantly, two patients with FPPA or UPA showed positive resection margins during surgery and three patients with FPPA or UPA showed recurrence in the remnant pancreas.
Conclusions
The presence of FPPA and UPA indicates lateral cancer extension in early-stage pancreatic cancer. Preoperative assessment of the pancreatic parenchyma may provide valuable insights for determining the extent of surgical resection.</description><identifier>ISSN: 0944-1174</identifier><identifier>ISSN: 1435-5922</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-024-02149-0</identifier><identifier>PMID: 39283502</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Abdominal Surgery ; Adenocarcinoma ; Aged ; Aged, 80 and over ; Atrophy ; Biliary Tract ; Carcinoma, Pancreatic Ductal - pathology ; Carcinoma, Pancreatic Ductal - surgery ; Colorectal Surgery ; Computed tomography ; Female ; Gastroenterology ; Hepatology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Original Article―Liver ; Original ―Liver, Pancreas, and Biliary Tract ; Pancreas ; Pancreas - diagnostic imaging ; Pancreas - pathology ; Pancreatic cancer ; Pancreatic Ducts - diagnostic imaging ; Pancreatic Ducts - pathology ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Parenchyma ; Retrospective Studies ; Stenosis ; Surgery ; Surgical Oncology ; Tomography, X-Ray Computed</subject><ispartof>Journal of gastroenterology, 2024-12, Vol.59 (12), p.1133-1142</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c400t-fa2512532cd94e0b9b46b4574b734b5a1d7de67fe1b68c3b8d29f06648d0a94c3</cites><orcidid>0000-0002-2138-1207</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-024-02149-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-024-02149-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39283502$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miki, Mika</creatorcontrib><creatorcontrib>Masuda, Atsuhiro</creatorcontrib><creatorcontrib>Takenaka, Mamoru</creatorcontrib><creatorcontrib>Shiomi, Hideyuki</creatorcontrib><creatorcontrib>Iemoto, Takao</creatorcontrib><creatorcontrib>Tsumura, Hidetaka</creatorcontrib><creatorcontrib>Tsujimae, Masahiro</creatorcontrib><creatorcontrib>Toyama, Hirochika</creatorcontrib><creatorcontrib>Sofue, Keitaro</creatorcontrib><creatorcontrib>Ueshima, Eisuke</creatorcontrib><creatorcontrib>Omoto, Shunsuke</creatorcontrib><creatorcontrib>Yoshida, Akihiro</creatorcontrib><creatorcontrib>Fukunaga, Tomohiro</creatorcontrib><creatorcontrib>Tanaka, Hidekazu</creatorcontrib><creatorcontrib>Nakano, Ryota</creatorcontrib><creatorcontrib>Ota, Shogo</creatorcontrib><creatorcontrib>Kobayashi, Takashi</creatorcontrib><creatorcontrib>Sakai, Arata</creatorcontrib><creatorcontrib>Kanzawa, Maki</creatorcontrib><creatorcontrib>Itoh, Tomoo</creatorcontrib><creatorcontrib>Kodama, Yuzo</creatorcontrib><creatorcontrib>SMT Study Group in Japan</creatorcontrib><title>Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of surgical resection. This study aimed to investigate the association of pancreatic atrophy pattern and intraductal cancer extension.
Methods
Thirty-two patients with early-stage pancreatic cancer who underwent surgery at five participating centers were enrolled. Pancreatic atrophy was defined as the narrowing of parenchyma compared to the surrounding parenchyma and was classified as either FPPA (partial atrophy surrounding the pancreatic duct stenosis) or UPA (global atrophy caudal to the site of duct stenosis). Intraductal cancer extension was defined as an extension exceeding 10 mm.
Results
Preoperative computed tomography revealed FPPA, UPA, and no parenchymal atrophy in 13, 13, and 6 patients. Cases with FPPA or UPA showed significantly longer cancer extensions than those without atrophy (
P
= 0.005 and
P
= 0.03, respectively). Intraductal cancer extension was present in all but one case of FPPA. 69% (9/13) of the cases with UPA showed intraductal cancer extension, whereas cases without atrophy showed no intraductal cancer extension. Importantly, two patients with FPPA or UPA showed positive resection margins during surgery and three patients with FPPA or UPA showed recurrence in the remnant pancreas.
Conclusions
The presence of FPPA and UPA indicates lateral cancer extension in early-stage pancreatic cancer. Preoperative assessment of the pancreatic parenchyma may provide valuable insights for determining the extent of surgical resection.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrophy</subject><subject>Biliary Tract</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Colorectal Surgery</subject><subject>Computed tomography</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Original Article―Liver</subject><subject>Original ―Liver, Pancreas, and Biliary Tract</subject><subject>Pancreas</subject><subject>Pancreas - diagnostic imaging</subject><subject>Pancreas - pathology</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Ducts - diagnostic imaging</subject><subject>Pancreatic Ducts - pathology</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Parenchyma</subject><subject>Retrospective Studies</subject><subject>Stenosis</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Tomography, X-Ray Computed</subject><issn>0944-1174</issn><issn>1435-5922</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EokvhD3BAlrhwCYy_kpgLqiq-pEpc4Gw5zqTrKrEX2yns3-AX47JLKRw4WJZnnnlnxi8hTxm8ZADdqwyghGqAy3qY1A3cIxsma0hpzu-TDWgpG8Y6eUIe5XwFwASo_iE5EZr3QgHfkB9nOUfnbfEx0DjRnQ0uYX06akuKu-2-hkrBFDL95suW-lCSHVdX7Ezxe8GQj5Vo07y_W3-E7IghOpucD3Gxr6mlyzrXPIaqShPWLnmHrvhrpLms4_4xeTDZOeOT431Kvrx7-_n8Q3Px6f3H87OLxkmA0kyWK8aV4G7UEmHQg2wHqTo5dEIOyrKxG7HtJmRD2zsx9CPXE7St7EewWjpxSt4cdHfrsOB4M1Cys9klv9i0N9F683cm-K25jNeGMSUZ70RVeHFUSPHrirmYxWeH82wDxjUbwaAFKXqmKvr8H_QqrinU_SrFpVYaRFspfqBc_ZSccLqdhoG58dwcPDfVc_PLcwO16NndPW5LfptcAXEAck2FS0x_ev9H9idy2Lwa</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Miki, Mika</creator><creator>Masuda, Atsuhiro</creator><creator>Takenaka, Mamoru</creator><creator>Shiomi, Hideyuki</creator><creator>Iemoto, Takao</creator><creator>Tsumura, Hidetaka</creator><creator>Tsujimae, Masahiro</creator><creator>Toyama, Hirochika</creator><creator>Sofue, Keitaro</creator><creator>Ueshima, Eisuke</creator><creator>Omoto, Shunsuke</creator><creator>Yoshida, Akihiro</creator><creator>Fukunaga, Tomohiro</creator><creator>Tanaka, Hidekazu</creator><creator>Nakano, Ryota</creator><creator>Ota, Shogo</creator><creator>Kobayashi, Takashi</creator><creator>Sakai, Arata</creator><creator>Kanzawa, Maki</creator><creator>Itoh, Tomoo</creator><creator>Kodama, Yuzo</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2138-1207</orcidid></search><sort><creationdate>20241201</creationdate><title>Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study</title><author>Miki, Mika ; Masuda, Atsuhiro ; Takenaka, Mamoru ; Shiomi, Hideyuki ; Iemoto, Takao ; Tsumura, Hidetaka ; Tsujimae, Masahiro ; Toyama, Hirochika ; Sofue, Keitaro ; Ueshima, Eisuke ; Omoto, Shunsuke ; Yoshida, Akihiro ; Fukunaga, Tomohiro ; Tanaka, Hidekazu ; Nakano, Ryota ; Ota, Shogo ; Kobayashi, Takashi ; Sakai, Arata ; Kanzawa, Maki ; Itoh, Tomoo ; Kodama, Yuzo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-fa2512532cd94e0b9b46b4574b734b5a1d7de67fe1b68c3b8d29f06648d0a94c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atrophy</topic><topic>Biliary Tract</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Colorectal Surgery</topic><topic>Computed tomography</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Original Article―Liver</topic><topic>Original ―Liver, Pancreas, and Biliary Tract</topic><topic>Pancreas</topic><topic>Pancreas - diagnostic imaging</topic><topic>Pancreas - pathology</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Ducts - diagnostic imaging</topic><topic>Pancreatic Ducts - pathology</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Parenchyma</topic><topic>Retrospective Studies</topic><topic>Stenosis</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miki, Mika</creatorcontrib><creatorcontrib>Masuda, Atsuhiro</creatorcontrib><creatorcontrib>Takenaka, Mamoru</creatorcontrib><creatorcontrib>Shiomi, Hideyuki</creatorcontrib><creatorcontrib>Iemoto, Takao</creatorcontrib><creatorcontrib>Tsumura, Hidetaka</creatorcontrib><creatorcontrib>Tsujimae, Masahiro</creatorcontrib><creatorcontrib>Toyama, Hirochika</creatorcontrib><creatorcontrib>Sofue, Keitaro</creatorcontrib><creatorcontrib>Ueshima, Eisuke</creatorcontrib><creatorcontrib>Omoto, Shunsuke</creatorcontrib><creatorcontrib>Yoshida, Akihiro</creatorcontrib><creatorcontrib>Fukunaga, Tomohiro</creatorcontrib><creatorcontrib>Tanaka, Hidekazu</creatorcontrib><creatorcontrib>Nakano, Ryota</creatorcontrib><creatorcontrib>Ota, Shogo</creatorcontrib><creatorcontrib>Kobayashi, Takashi</creatorcontrib><creatorcontrib>Sakai, Arata</creatorcontrib><creatorcontrib>Kanzawa, Maki</creatorcontrib><creatorcontrib>Itoh, Tomoo</creatorcontrib><creatorcontrib>Kodama, Yuzo</creatorcontrib><creatorcontrib>SMT Study Group in Japan</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miki, Mika</au><au>Masuda, Atsuhiro</au><au>Takenaka, Mamoru</au><au>Shiomi, Hideyuki</au><au>Iemoto, Takao</au><au>Tsumura, Hidetaka</au><au>Tsujimae, Masahiro</au><au>Toyama, Hirochika</au><au>Sofue, Keitaro</au><au>Ueshima, Eisuke</au><au>Omoto, Shunsuke</au><au>Yoshida, Akihiro</au><au>Fukunaga, Tomohiro</au><au>Tanaka, Hidekazu</au><au>Nakano, Ryota</au><au>Ota, Shogo</au><au>Kobayashi, Takashi</au><au>Sakai, Arata</au><au>Kanzawa, Maki</au><au>Itoh, Tomoo</au><au>Kodama, Yuzo</au><aucorp>SMT Study Group in Japan</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>59</volume><issue>12</issue><spage>1133</spage><epage>1142</epage><pages>1133-1142</pages><issn>0944-1174</issn><issn>1435-5922</issn><eissn>1435-5922</eissn><abstract>Background
Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of surgical resection. This study aimed to investigate the association of pancreatic atrophy pattern and intraductal cancer extension.
Methods
Thirty-two patients with early-stage pancreatic cancer who underwent surgery at five participating centers were enrolled. Pancreatic atrophy was defined as the narrowing of parenchyma compared to the surrounding parenchyma and was classified as either FPPA (partial atrophy surrounding the pancreatic duct stenosis) or UPA (global atrophy caudal to the site of duct stenosis). Intraductal cancer extension was defined as an extension exceeding 10 mm.
Results
Preoperative computed tomography revealed FPPA, UPA, and no parenchymal atrophy in 13, 13, and 6 patients. Cases with FPPA or UPA showed significantly longer cancer extensions than those without atrophy (
P
= 0.005 and
P
= 0.03, respectively). Intraductal cancer extension was present in all but one case of FPPA. 69% (9/13) of the cases with UPA showed intraductal cancer extension, whereas cases without atrophy showed no intraductal cancer extension. Importantly, two patients with FPPA or UPA showed positive resection margins during surgery and three patients with FPPA or UPA showed recurrence in the remnant pancreas.
Conclusions
The presence of FPPA and UPA indicates lateral cancer extension in early-stage pancreatic cancer. Preoperative assessment of the pancreatic parenchyma may provide valuable insights for determining the extent of surgical resection.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>39283502</pmid><doi>10.1007/s00535-024-02149-0</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2138-1207</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0944-1174 |
| ispartof | Journal of gastroenterology, 2024-12, Vol.59 (12), p.1133-1142 |
| issn | 0944-1174 1435-5922 1435-5922 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11541273 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Abdominal Surgery Adenocarcinoma Aged Aged, 80 and over Atrophy Biliary Tract Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - surgery Colorectal Surgery Computed tomography Female Gastroenterology Hepatology Humans Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Original Article―Liver Original ―Liver, Pancreas, and Biliary Tract Pancreas Pancreas - diagnostic imaging Pancreas - pathology Pancreatic cancer Pancreatic Ducts - diagnostic imaging Pancreatic Ducts - pathology Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Parenchyma Retrospective Studies Stenosis Surgery Surgical Oncology Tomography, X-Ray Computed |
| title | Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study |
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