Magnetic resonance imaging surveillance detects early-stage pancreatic cancer in carriers of a p16-Leiden mutation

Hans F A Vasen, Martin Wasser, Anneke Van Mil, Rob A. Tollenaar, Marja Konstantinovski, Nelleke A. Gruis, Wilma Bergman, Frederik J. Hes, Daniel W. Hommes, G. Johan A Offerhaus, Hans Morreau, Bert A. Bonsing, Wouter H. De Vos Tot Nederveen Cappel

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims: Surveillance of high-risk groups for pancreatic cancer might increase early detection and treatment outcomes. Individuals with germline mutations in p16-Leiden have a lifetime risk of 15% to 20% of developing pancreatic cancer. We assessed the feasibility of detecting pancreatic cancer at an early stage and investigated the outcomes of patients with neoplastic lesions. Methods: Individuals with germline mutations in p16-Leiden (N = 79; 31 male; mean age, 56 years; range, 3972 years) were offered annual surveillance by magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP). Those found to have neoplastic lesions were offered options for surgery or intensive follow-up. Individuals found to have possible neoplastic lesions were examined again by MRI/MRCP within 2 to 4 months. Results: After a median follow-up period of 4 years (range, 010 years), pancreatic cancer was diagnosed in 7 patients (9%). The mean age at diagnosis was 59 years (range, 4972 years). Three of the tumors were present at the first examination, and 4 were detected after a negative result in the initial examination. All 7 patients had a resectable lesion; 5 underwent surgery, 3 had an R0 resection, and 2 had lymph node metastases. Possible precursor lesions (ie, duct ectasias, based on MRCP) were found in 9 individuals (11%). Conclusions: MRI/MRCP detects small, solid pancreatic tumors and small duct ectasias. Although surveillance increases the rate of resectability, carriers of a p16-Leiden mutation develop agressive tumors.

Original languageEnglish (US)
Pages (from-to)850-856
Number of pages7
JournalGastroenterology
Volume140
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

Keywords

  • Cancer Prevention
  • Cancer Screening
  • Imaging Studies
  • Tumor Suppressor

ASJC Scopus subject areas

  • Gastroenterology

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