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Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis.

Abstract

BACKGROUND

The timeline of progression of pancreatic cancer from resectable to unresectable disease is unknown. New-onset diabetes often occurs in pancreatic cancer. It is unclear if the cancer is resectable at the onset of diabetes. We (a) determined the resectability of pancreatic cancer on abdominal CT scans done prior to clinical diagnosis and (b) correlated resectability with onset of diabetes.

METHODS

All CT scans done at diagnosis or before pancreatic cancer diagnosis were reviewed and pancreatic changes classified as normal, potentially resectable, or unresectable pancreatic cancer. Fasting blood glucose values obtained at and prior to diagnosis were available in 18 patients. The date of onset of diabetes and the interval between onset of diabetes and diagnosis of cancer were noted.

RESULTS

Thirty patients fulfilled inclusion criteria. Prior to diagnosis, 28 patients had 38 CT scans done at a median of 18 months (range 1-41) before cancer diagnosis. At cancer diagnosis, only 7/30 patients could undergo margin-negative surgical resection. CT scans done >/=6 months prior to diagnosis showed either a normal pancreas (N = 20) or a resectable mass (N = 6); none had unresectable cancer. The mean interval between onset of diabetes and diagnosis of pancreatic cancer was 10 months (range 5-29 months). At the onset of diabetes, 3 patients had normal pancreas, 6 had resectable, and 4 had unresectable pancreatic cancer.

CONCLUSIONS

Pancreatic cancer is frequently undetectable or resectable on CT scans done >/=6 months prior to clinical diagnosis. At onset of diabetes, pancreatic cancers are generally resectable.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

    , ,

    Source

    The American journal of gastroenterology 102:10 2007 Oct pg 2157-63

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Blood Glucose
    Cohort Studies
    Diabetes Mellitus
    Fasting
    Female
    Humans
    Male
    Middle Aged
    Pancreatic Neoplasms
    Retrospective Studies
    Time Factors
    Tomography, X-Ray Computed

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17897335

    Citation

    Pelaez-Luna, Mario, et al. "Resectability of Presymptomatic Pancreatic Cancer and Its Relationship to Onset of Diabetes: a Retrospective Review of CT Scans and Fasting Glucose Values Prior to Diagnosis." The American Journal of Gastroenterology, vol. 102, no. 10, 2007, pp. 2157-63.
    Pelaez-Luna M, Takahashi N, Fletcher JG, et al. Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis. Am J Gastroenterol. 2007;102(10):2157-63.
    Pelaez-Luna, M., Takahashi, N., Fletcher, J. G., & Chari, S. T. (2007). Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis. The American Journal of Gastroenterology, 102(10), pp. 2157-63.
    Pelaez-Luna M, et al. Resectability of Presymptomatic Pancreatic Cancer and Its Relationship to Onset of Diabetes: a Retrospective Review of CT Scans and Fasting Glucose Values Prior to Diagnosis. Am J Gastroenterol. 2007;102(10):2157-63. PubMed PMID: 17897335.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis. AU - Pelaez-Luna,Mario, AU - Takahashi,Naoki, AU - Fletcher,Joel G, AU - Chari,Suresh T, PY - 2007/9/28/pubmed PY - 2007/12/6/medline PY - 2007/9/28/entrez SP - 2157 EP - 63 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 102 IS - 10 N2 - BACKGROUND: The timeline of progression of pancreatic cancer from resectable to unresectable disease is unknown. New-onset diabetes often occurs in pancreatic cancer. It is unclear if the cancer is resectable at the onset of diabetes. We (a) determined the resectability of pancreatic cancer on abdominal CT scans done prior to clinical diagnosis and (b) correlated resectability with onset of diabetes. METHODS: All CT scans done at diagnosis or before pancreatic cancer diagnosis were reviewed and pancreatic changes classified as normal, potentially resectable, or unresectable pancreatic cancer. Fasting blood glucose values obtained at and prior to diagnosis were available in 18 patients. The date of onset of diabetes and the interval between onset of diabetes and diagnosis of cancer were noted. RESULTS: Thirty patients fulfilled inclusion criteria. Prior to diagnosis, 28 patients had 38 CT scans done at a median of 18 months (range 1-41) before cancer diagnosis. At cancer diagnosis, only 7/30 patients could undergo margin-negative surgical resection. CT scans done >/=6 months prior to diagnosis showed either a normal pancreas (N = 20) or a resectable mass (N = 6); none had unresectable cancer. The mean interval between onset of diabetes and diagnosis of pancreatic cancer was 10 months (range 5-29 months). At the onset of diabetes, 3 patients had normal pancreas, 6 had resectable, and 4 had unresectable pancreatic cancer. CONCLUSIONS: Pancreatic cancer is frequently undetectable or resectable on CT scans done >/=6 months prior to clinical diagnosis. At onset of diabetes, pancreatic cancers are generally resectable. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17897335/Resectability_of_presymptomatic_pancreatic_cancer_and_its_relationship_to_onset_of_diabetes:_a_retrospective_review_of_CT_scans_and_fasting_glucose_values_prior_to_diagnosis_ L2 - http://Insights.ovid.com/pubmed?pmid=17897335 DB - PRIME DP - Unbound Medicine ER -