Chronic pancreatitis and resectable synchronous pancreatic carcinoma: A survival analysis

Pancreatology. 2018 Jun;18(4):394-398. doi: 10.1016/j.pan.2018.04.009. Epub 2018 Apr 25.

Abstract

Background/objectives: Chronic pancreatitis (CP) is a risk factor for pancreatic cancer (PDAC). CP and PDAC are characterized by an abundance of desmoplastic tissue. The effect of this pancreatic desmoplastic tissue on PDAC is poorly understood. In literature, negative and positive effects on the natural course of PDAC have been discussed. The present analysis aims to assess the impact of CP on patients with resectable synchronous PDAC regarding short- and long-term survival.

Methods: All patients who underwent pancreatic resection at our institution from January 2005 to January 2014 were retrospectively evaluated. Definition of CP was based on clinical and radiological aspects and histological confirmation as used previously. We identified patients with CP, CP and PDAC, and PDAC without CP and compared perioperative course and survival. Statistical analysis was performed by chi-square, Kruskal-Wallis/Mann-Whitney-U and Breslow survival analysis. P-values <0.05 were defined as statistically significant.

Results: 159 patients met our inclusion criteria for CP. 49 of them (30.8%) had synchronous PDAC. 145 patients had PDAC without a history of CP. There was a more advanced nodal involvement in PDAC patients with CP. Perioperative outcome and long-term survival of PDAC patients with and without CP did not differ significantly.

Conclusion: In a large clinical series CP had no impact on survival of patients with PDAC after resection with curative intent.

Keywords: Chronic pancreatitis; Desmoplastic stroma; Survival; Synchronous pancreatic cancer.

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas / pathology
  • Pancreatectomy
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Pancreatitis, Chronic / mortality*
  • Pancreatitis, Chronic / pathology
  • Pancreatitis, Chronic / surgery
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Treatment Outcome