Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis
The presence of main pancreatic duct (MPD) dilatation is important for diagnosing pancreatic ductal adenocarcinomas (PDACs). However, we occasionally encounter PDAC cases without MPD dilatation. The objectives of this study were to compare the clinical findings and prognosis of pathologically diagno...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/5/963 |
| _version_ | 1827752749038567424 |
|---|---|
| author | Takuya Takayanagi Yusuke Sekino Noriki Kasuga Ken Ishii Hajime Nagase Atsushi Nakajima |
| author_facet | Takuya Takayanagi Yusuke Sekino Noriki Kasuga Ken Ishii Hajime Nagase Atsushi Nakajima |
| author_sort | Takuya Takayanagi |
| collection | DOAJ |
| description | The presence of main pancreatic duct (MPD) dilatation is important for diagnosing pancreatic ductal adenocarcinomas (PDACs). However, we occasionally encounter PDAC cases without MPD dilatation. The objectives of this study were to compare the clinical findings and prognosis of pathologically diagnosed PDAC cases with and without MPD dilatation and to extract factors related to the prognosis of PDAC. The 281 patients pathologically diagnosed with PDAC were divided into two groups: the dilatation group (<i>n</i> = 215), consisting of patients with MPD dilatation of 3 mm or more, and the non-dilatation group (<i>n</i> = 66), consisting of patients with MPD dilatation less than 3 mm. We found that the non-dilatation group had more cancers in the pancreatic tail, more advanced disease stage, lower resectability, and worse prognoses than the dilatation group. Clinical stage and history of surgery or chemotherapy were identified as significant prognostic factors for PDAC, while tumor location was not. Endoscopic ultrasonography (EUS), diffusion-weighted magnetic resonance imaging (DW-MRI), and contrast-enhanced computed tomography had a high tumor detection rate for PDAC even in the non-dilatation group. Construction of a diagnostic system centered on EUS and DW-MRI is necessary for the early diagnosis of PDAC without MPD dilatation, which can improve its prognosis. |
| first_indexed | 2024-03-11T07:27:28Z |
| format | Article |
| id | doaj.art-3a5b644387b34edb94b20a3e2dd9b088 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T07:27:28Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-3a5b644387b34edb94b20a3e2dd9b0882023-11-17T07:30:35ZengMDPI AGDiagnostics2075-44182023-03-0113596310.3390/diagnostics13050963Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective AnalysisTakuya Takayanagi0Yusuke Sekino1Noriki Kasuga2Ken Ishii3Hajime Nagase4Atsushi Nakajima5Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama 222-0036, JapanDepartment of Gastroenterology, Yokohama Rosai Hospital, Yokohama 222-0036, JapanDepartment of Gastroenterology, Yokohama Rosai Hospital, Yokohama 222-0036, JapanDepartment of Gastroenterology, Yokohama Rosai Hospital, Yokohama 222-0036, JapanDepartment of Gastroenterology, Yokohama Rosai Hospital, Yokohama 222-0036, JapanDepartment of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama 236-0004, JapanThe presence of main pancreatic duct (MPD) dilatation is important for diagnosing pancreatic ductal adenocarcinomas (PDACs). However, we occasionally encounter PDAC cases without MPD dilatation. The objectives of this study were to compare the clinical findings and prognosis of pathologically diagnosed PDAC cases with and without MPD dilatation and to extract factors related to the prognosis of PDAC. The 281 patients pathologically diagnosed with PDAC were divided into two groups: the dilatation group (<i>n</i> = 215), consisting of patients with MPD dilatation of 3 mm or more, and the non-dilatation group (<i>n</i> = 66), consisting of patients with MPD dilatation less than 3 mm. We found that the non-dilatation group had more cancers in the pancreatic tail, more advanced disease stage, lower resectability, and worse prognoses than the dilatation group. Clinical stage and history of surgery or chemotherapy were identified as significant prognostic factors for PDAC, while tumor location was not. Endoscopic ultrasonography (EUS), diffusion-weighted magnetic resonance imaging (DW-MRI), and contrast-enhanced computed tomography had a high tumor detection rate for PDAC even in the non-dilatation group. Construction of a diagnostic system centered on EUS and DW-MRI is necessary for the early diagnosis of PDAC without MPD dilatation, which can improve its prognosis.https://www.mdpi.com/2075-4418/13/5/963main pancreatic ductpancreatic ductal adenocarcinomaendoscopic ultrasound |
| spellingShingle | Takuya Takayanagi Yusuke Sekino Noriki Kasuga Ken Ishii Hajime Nagase Atsushi Nakajima Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis Diagnostics main pancreatic duct pancreatic ductal adenocarcinoma endoscopic ultrasound |
| title | Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis |
| title_full | Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis |
| title_fullStr | Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis |
| title_full_unstemmed | Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis |
| title_short | Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis |
| title_sort | clinical features and prognostic impact of pancreatic ductal adenocarcinoma without dilatation of the main pancreatic duct a single center retrospective analysis |
| topic | main pancreatic duct pancreatic ductal adenocarcinoma endoscopic ultrasound |
| url | https://www.mdpi.com/2075-4418/13/5/963 |
| work_keys_str_mv | AT takuyatakayanagi clinicalfeaturesandprognosticimpactofpancreaticductaladenocarcinomawithoutdilatationofthemainpancreaticductasinglecenterretrospectiveanalysis AT yusukesekino clinicalfeaturesandprognosticimpactofpancreaticductaladenocarcinomawithoutdilatationofthemainpancreaticductasinglecenterretrospectiveanalysis AT norikikasuga clinicalfeaturesandprognosticimpactofpancreaticductaladenocarcinomawithoutdilatationofthemainpancreaticductasinglecenterretrospectiveanalysis AT kenishii clinicalfeaturesandprognosticimpactofpancreaticductaladenocarcinomawithoutdilatationofthemainpancreaticductasinglecenterretrospectiveanalysis AT hajimenagase clinicalfeaturesandprognosticimpactofpancreaticductaladenocarcinomawithoutdilatationofthemainpancreaticductasinglecenterretrospectiveanalysis AT atsushinakajima clinicalfeaturesandprognosticimpactofpancreaticductaladenocarcinomawithoutdilatationofthemainpancreaticductasinglecenterretrospectiveanalysis |