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Pancreatic cancer after surgery for chronic pancreatitis
1Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN, USA.
Background:
Chronic pancreatitis is known to be a risk factor for pancreatic cancer.
Aims:
To identify patients who were diagnosed with pancreatic cancer after undergoing surgery for histologically documented chronic pancreatitis.
Patients/Methods:
Records of 484 consecutive patients who underwent surgery for chronic pancreatitis from 1976 to 1997 were reviewed.
Results:
Pancreatic cancer was diagnosed after a mean of 3.4 years (range: 2 months-1 years) in 14 patients (2.9%). In four patients, pancreatic cancer became evident within 12 months of surgery for chronic pancreatitis, suggesting cancer was present at the original surgery. Cancer presented with recurrent or persistent pain, jaundice, and/or weight loss. Pancreatic resection was possible in eight patients, but in the others, the cancer was inoperable. There was one long-term survivor (alive 14 years postoperatively), but for theothers mean survival was 10 months (16 months after resection vs. 4 months for inoperable cancer).
Conclusion:
Pancreatic malignancy should be suspected in patients who have had surgery for chronic pancreatitis when symptoms (such as recurrent pain, jaundice, weight loss, or anorexia) recur. Attempts at curative pancreatic resection are indicated and can offer palliation and the potential for a cure.