Asymptomatic Pancreatic Cancer: Does Incidental Detection Impact Long-Term Outcomes?

Yoshinori Takeda, Akio Saiura, Yu Takahashi, Yosuke Inoue, Takeaki Ishizawa, Yoshihiro Mise, Masaru Matsumura, Hirofumi Ichida, Ryota Matsuki, Masayuki Tanaka, Hiromichi Ito

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Detection of pancreatic ductal adenocarcinoma (PDAC) in asymptomatic patients is very rare, and the clinical implication of early detection of asymptomatic PDAC remains unclear. Methods: This retrospective study included 569 consecutive patients with PDAC treated in our institution (250 underwent surgical resection and 319 had unresectable PDAC). The patients’ demographics, tumor locations, pathologic stages, treatment, and overall survival (OS) were compared between the asymptomatic and symptomatic patients. Results: In total, 163 (29%) patients presented without subjective symptoms. These patients had an earlier stage of PDAC on presentation (p < 0.001), higher resectability rate (64 vs. 36%, p < 0.001), and higher 5-year OS rate (18 vs. 7%, p < 0.001) than patients with symptoms. Among the patients who underwent resection, asymptomatic patients did not have a significantly higher chance of complete resection (88 vs. 78%, p = 0.06) or 5-year OS rate (23 vs. 22%, p = 0.09). However, symptomatic patients more often required complex operations such as concomitant vascular resection and reconstruction (57 vs. 29%, p < 0.001). Conclusions: Asymptomatic PDAC is associated with better long-term outcomes than symptomatic PDAC because of the earlier stage at presentation and higher chance of resectability. Our findings highlight the potential implication of screening programs for early detection of PDAC in selected high-risk populations.

Original languageEnglish
Pages (from-to)1287-1295
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume21
Issue number8
DOIs
Publication statusPublished - 2017 Aug 1
Externally publishedYes

Keywords

  • Asymptomatic pancreatic cancer
  • Resection rate
  • Screening
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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