Cancer risk jumps after pancreatitis surgery

  • Zheng Z & al.
  • BMC Surg
  • 8 jul. 2019

  • de Craig Hicks
  • Clinical Essentials
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Takeaway

  • Patients who undergo surgery for chronic pancreatitis (CP) are subsequently at much higher risk of developing pancreatic cancer.

Why this matters

  • Clinicians should be vigilant about monitoring patients for pancreatic cancer after CP surgery, particularly those with newly diagnosed diabetes.

Study design

  • Researchers reviewed the health records of patients who underwent surgery for histologically confirmed CP (N=650), using univariate and multivariate Cox regression analyses to identify independent risk factors associated with progression of pancreatic cancer.
  • Funding: Sichuan University; National Natural Science Foundation of China; Scientific and Technological Support Program of Sichuan Province.

Key results

  • Postoperative cancer was detected in 12 patients (1.8%) after a median follow-up of 4.4 years (range, 11 months-10 years).
  • The standardized incidence ratio was 68.12 (95% CI, 35.20-118.99), based on an expected incidence of 0.176.
  • Independent risk factors included:
    • Time to surgery: HR, 1.005 (95% CI, 1.002-1.008; P=.002).
    • Postoperative diagnosis of endocrine insufficiency: HR, 10.672 (2.567-44.372; P=.001).

Limitations

  • The study was retrospective and included a small number of patients who developed pancreatic cancer, limiting statistical power.