Endoscopy 2022; 54(S 01): S47-S48
DOI: 10.1055/s-0042-1744656
Abstracts | ESGE Days 2022
ESGE Days 2022 Oral presentations
08:30–09:30 Friday, 29 April 2022 Club A. Role of EUS in detecting malignancy in pancreatic cystic lesions

INCIDENCE OF PANCREATIC CANCER WITHIN PANCREATIC CYSTIC NEOPLASM: 6-YEAR RESULTS FROM A NATIONWIDE PATHOLOGY DATABASE

N. van Huijgevoort
1   Amsterdam UMC, University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, Netherlands
,
M. Gorris
1   Amsterdam UMC, University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, Netherlands
2   Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, Netherlands
,
A. Farina Sarasqueta
3   Amsterdam UMC, University of Amsterdam, Department of Pathology, Amsterdam, Netherlands
,
L. Brosens
4   University Medical Centre Utrecht, Utrecht University, Department of Pathology, Utrecht, Netherlands
,
H. van Santvoort
5   University Medical Centre Utrecht, Utrecht University, Department of Surgery, Utrecht, Netherlands
,
B. Groot Koerkamp
6   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Surgery, Rotterdam, Netherlands
,
M. Bruno
7   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
,
M. Besselink
2   Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, Netherlands
,
J. van Hooft
8   Leiden University Medical Center, Department of Gastroenterology and Hepatology, Leiden, Netherlands
› Author Affiliations
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Aims Pancreatic cystic neoplasms (PCN) are known precursor lesions for pancreatic ductal adenocarcinoma (PDAC) and thereby pose an opportunity for early detection and curative treatment. The aim of this national retrospective study was to investigate the incidence of PDAC arising from PCN in the Netherlands.

Methods Clinical information from all patients who underwent pancreatic resection for PDAC between 2013 – 2018 was retrieved from the Netherlands Cancer Registry (NCR) and matched with the corresponding pathology reports from the automated national pathology database (PALGA). Primary outcome was the incidence of PDAC arising from PCN. Secondary outcomes were the overall survival between primary PDAC and PDAC arising from PCN and the incidence PDAC as opposed to PCN.

Results After assessing 2405 patients for eligibility, 1991 patients were included (Fig. 1). Primary PDAC was diagnosed in 1819 patients (91%), of which 50 patients (3%) had PDAC as opposed to PCN. Invasive PCN was diagnosed in 176 patients (9%), the majority being invasive IPMN (n=168, 8% of total cohort). Overall survival was significantly higher in patients with PDAC arising from PCN (53% vs. 24%, p=0.000) after a median follow-up period of 534 days (IQR 318-894) from diagnosis. This difference remained significant when adjusted for TNM stage in Cox regression analysis (Hazard ratio 0.530 [95%CI 0.422-0.665]).

Zoom Image
Fig. 1

Table 1

PDAC arising from PCN (n=176)

Primary PDAC (n=1819)

p-value

Male, n (%)

83 (47)

955 (53)

0.176

Age in years, median (IQR)

69 (62-74)

68 (61-74)

0.481

Perioperative therapy, n (%)

Chemotherapy

92 (52)

1119 (62)

0.009*a

Radiotherapy

1 (.6)

74 (4)

0.037*a

pTNM stage, n (%)

0.000*

1A

34 (19)

67 (4)

1B

23 (13)

128 (7)

2A

25 (15)

251 (14)

2B

71 (40)

1042 (57)

3

18 (10)

270 (15)

4

3 (2)

61 (3)

Conclusions This nationwide cohort study showed that 9% of resected PDAC was diagnosed as PDAC arising from PCN. Patients with PDAC arising from PCN showed longer survival when compared to patients with primary PDAC.



Publication History

Article published online:
14 April 2022

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