Acute pancreatitis may reveal pancreatic cancer at earlier stage

Surgical intervention after 24.5 days of acute pancreatitis may be beneficial for reducing postoperative complications.
Surgical intervention after 24.5 days of acute pancreatitis may be beneficial for reducing postoperative complications.

Acute pancreatitis may be an indicator for pancreatic cancer at an earlier stage, according to a study published in Medicine.

Shaojun Li, M Med, and Bole Tian, PhD, from the West China Hospital in Sichuan, China, identified 47 consecutive patients with  pancreatic cancer who presented with acute pancreatitis between January 2009 and November 2016. Of the patients, 35 (74.5%) were men with a mean age of 52 years. Clinical features, clinicopathologic variables, postoperative complications, and follow-up evaluations of patients were recorded from the database.

Clinical features of acute pancreatitis include abdominal pain, jaundice, and weight loss. The timing of surgery was identified by receiver operating characteristic (ROC) curve. Preoperative, intraoperative, and postoperative parameters were collected to determine operative timing of surgical intervention. Survival curves were plotted using the Kaplan—Meier method, and survival data were analyzed using the log-rank test.

Of the 47 patients included, acute pancreatitis was clinically mild in 45 (95.7%) and severe in 2 (4.3%). Radical surgery was performed in 32 (68.1%) of cases, palliative surgery in 7 (14.9%), and biopsies in 8 (17.0%). A total of 2 (8.0%) patients were needed for vascular resection and reconstruction. The diagnosis of pancreatic cancer occurred at a median of 101 days, and 27 (57.4%) patients were diagnosed in less than 2 months after acute pancreatitis diagnosis.

The timing of surgery was calculated from the date of the first attack of acute pancreatitis to the surgery. The best cutoff point was 24.5 days according to the ROC curve. A total of 25 (64.1%) patients received surgery at or before 24.5 days from diagnosis of pancreatic cancer. Postoperative complications occurred in 12 (30.8%) patients. The median follow-up for patients was 24 months with a patient survival rate at 1 year of 23.4%. The median survival in patients with vascular resection and reconstruction was 18 months, compared with 10 months in patients without vascular resection.

According to the authors, “this retrospective study supports the assumption that acute pancreatitis is the early presenting clinical symptom of pancreatic cancer.”

Reference

  1. Li S, Tian B. Acute pancreatitis in patients with pancreatic cancer: Timing of surgery and survival duration. Medicine (Baltimore). January 2017. doi: 10.1097/MD.0000000000005908
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