2022 Volume 60 Issue 1 Pages 32-40
Objective (background): Pancreatic cancer is known to have a poor prognosis. Only 20-30% of patients have resectable tumors. Therefore, it is important to identify resectable pancreatic cancer efficiently. This study aimed to clarify the diagnostic opportunity and clinical features of resectable pancreatic cancer.
Subjects and methods: The authors reviewed diagnostic opportunities and clinical features of 246 patients (74 with resectable and 172 with borderline/unresectable tumors) who were diagnosed with pancreatic cancer at Suzuka General Hospital from January 2013 to November 2019 (a single center retrospective analysis).
Results: Resectable pancreatic cancer was efficiently diagnosed by medical check-up (10/13, 76.9%) or regular examination for intraductal papillary mucinous neoplasm (IPMN) (5/5, 100%). Multivariate logistic regression analyses revealed that no symptoms at the diagnosis {Odds ratio (OR) 6.21; 95% CI 2.88-13.4, P<0.001}, tumor confined to the pancreatic head (OR 3.13; 95% CI 1.60-6.11, P<0.001) were positive predictors of resectable pancreatic cancer, and new onset or worsening of diabetes (OR 0.31; 95% CI 0.14-0.71, P<0.01) and CA19-9≥37 IU/ml (OR 0.44; 95% CI 0.20-0.96, P=0.039) were negative predictors. Among risk factors for pancreatic cancer, only 25.8% (8/31) of IPMN and neither pancreatic cysts nor chronic pancreatitis were detected before the diagnosis of pancreatic cancer.
Conclusions: To detect resectable pancreatic cancers, it is important to diagnose pancreatic cancer when patients are asymptomatic and CA19-9 negative. Risk factors such as IPMN were often not recognized before the diagnosis of pancreatic cancer; thus it is necessary to detect risk factors more efficiently.
