Outcomes of a 3-Year Prospective Surveillance in Individuals at High Risk of Pancreatic Cancer-Reference-Cited by-同舟云学术

Outcomes of a 3-Year Prospective Surveillance in Individuals at High Risk of Pancreatic Cancer

Published:2023-11-10 Issue: Volume: Page:
ISSN:0002-9270
Container-title:American Journal of Gastroenterology
language:en
Short-container-title:Am J Gastroenterol

Author:

Paiella Salvatore¹^ORCID,Capurso Gabriele²^ORCID,Carrara Silvia³^ORCID,Secchettin Erica⁴,Casciani Fabio¹^ORCID,Frigerio Isabella⁵^ORCID,Zerbi Alessandro⁶⁷^ORCID,Archibugi Livia²^ORCID,Bonifacio Cristiana⁸,Malleo Giuseppe¹^ORCID,Cavestro Giulia Martina⁹^ORCID,Barile Monica¹⁰,Larghi Alberto¹¹,Assisi Daniela¹²^ORCID,Fantin Alberto¹³^ORCID,Milanetto Anna Caterina¹⁴^ORCID,Fabbri Carlo¹⁵,Casadei Riccardo¹⁶¹⁷,Donato Giulio¹⁸^ORCID,Sassatelli Romano¹⁹^ORCID,De Marchi Giulia²⁰^ORCID,Di Matteo Francesco Maria²¹^ORCID,Arcangeli Valentina²²^ORCID,Panzuto Francesco²³²⁴^ORCID,Puzzono Marta⁸^ORCID,Dal Buono Arianna³,Pezzilli Raffaele²⁵^ORCID,Salvia Roberto¹,Rizzatti Gianenrico¹¹^ORCID,Casadio Marco¹²^ORCID,Franco Monica¹³^ORCID,Butturini Giovanni⁵^ORCID,Pasquali Claudio¹⁴^ORCID,Coluccio Chiara¹⁵^ORCID,Ricci Claudio¹⁶¹⁷,Cicchese Noemi¹⁸^ORCID,Sereni Giuliana¹⁹^ORCID,de Pretis Nicolò²⁰,Stigliano Serena²¹^ORCID,Rudnas Britt²⁶^ORCID,Marasco Matteo²³^ORCID,Lionetto Gabriella¹^ORCID,Arcidiacono Paolo Giorgio²^ORCID,Terrin Maria³,Crovetto Anna¹^ORCID,Mannucci Alessandro⁹^ORCID,Laghi Luigi²⁷²⁸^ORCID,Bassi Claudio¹,Falconi Massimo²⁹

Affiliation:

1. General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy;

2. Pancreatico-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy;

3. Department of Gastroenterology, Endoscopy Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy;

4. Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy;

5. Hepatopancreatobiliary Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy;

6. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy;

7. Pancreatic Surgery Department, IRCCS Humanitas Research Hospital, Rozzano, Italy;

8. Radiology Department, Humanitas Research Hospital-IRCCS, Milan, Italy;

9. Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy;

10. Genetics and Cancer Prevention, Humanitas Research Hospital-IRCCS, Milan, Italy;

11. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;

12. UOSD Gastroenterologia ed Endoscopia Digestiva Istituto Nazionale Tumori Regina Elena, Rome, Italy;

13. Gastroenterology Unit Veneto Institute of Oncology IOV-IRCCS, Padua, Italy;

14. Department of Surgery, Oncology and Gastroenterology, Pancreatic and Endocrine Surgery Unit, University of Padova, Padova, Italy;

15. Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy;

16. Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy;

17. Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy;

18. Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy;

19. Unit of Gastroenterology and Digestive Endoscopy, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy;

20. Gastroenterology Unit, Department of Medicine, University of Verona, Verona Italy;

21. Digestive Endoscopy Unit, University Campus Bio-Medico, Rome, Italy;

22. Romagna Cancer Registry IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” (IRST), Meldola, Forlì-Cesena, Italy;

23. Digestive Disease Unit, Sant' Andrea University Hospital, Rome, Italy;

24. Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy;

25. Department of Gastroenterology, San Carlo Hospital, Potenza;

26. Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” (IRST), Meldola, Forlì-Cesena, Italy;

27. Department of Medicine and Surgery, University of Parma, Parma, Italy;

28. Laboratory of Molecular Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Italy;

29. Division of Pancreatic and Transplantation Surgery, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Milan, Italy; Vita-Salute University, Milan, Italy.

Abstract

INTRODUCTION: Pancreatic cancer (PC) surveillance of high-risk individuals (HRI) is becoming more common worldwide, aiming at anticipating PC diagnosis at a preclinical stage. In 2015, the Italian Registry of Families at Risk of Pancreatic Cancer was created. We aimed to assess the prevalence and incidence of pancreatic findings, oncological outcomes, and harms 7 years after the Italian Registry of Families at Risk of Pancreatic Cancer inception, focusing on individuals with at least a 3-year follow-up or developing events before. METHODS: HRI (subjects with a family history or mutation carriers with/without a family history were enrolled in 18 centers). They underwent annual magnetic resonance with cholangiopancreatography or endoscopic ultrasound (NCT04095195). RESULTS: During the study period (June 2015–September 2022), 679 individuals were enrolled. Of these, 524 (77.2%) underwent at least baseline imaging, and 156 (29.8%) with at least a 3-year follow-up or pancreatic malignancy/premalignancy-related events, and represented the study population. The median age was 51 (interquartile range 16) years. Familial PC cases accounted for 81.4% of HRI and individuals with pathogenic variant for 18.6%. Malignant (n = 8) and premalignant (1 PanIN3) lesions were found in 9 individuals. Five of these 8 cases occurred in pathogenic variant carriers, 4 in familial PC cases (2 tested negative at germline testing and 2 others were not tested). Three of the 8 PC were stage I. Five of the 8 PC were resectable, 3 Stage I, all advanced cases being prevalent. The 1-, 2-, and 3-year cumulative hazard of PC was 1.7%, 2.5%, and 3%, respectively. Median overall and disease-free survival of patients with resected PC were 18 and 12 months (95% CI not computable). Considering HRI who underwent baseline imaging, 6 pancreatic neuroendocrine neoplasms (1 resected) and 1 low-yield surgery (low-grade mixed-intraductal papillary mucinous neoplasm) were also reported. DISCUSSION: PC surveillance in a fully public health care system is feasible and safe, and leads to early PC or premalignant lesions diagnoses, mostly at baseline but also over time.

Funder

Associazione Medica Forlivese Luigi Fontana

Fondazione Nadia Valsecchi

Oltre La Ricerca

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Gastroenterology,Hepatology

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