Surveillance of High-Risk Group May Downstage Pancreatic Cancer

WEDNESDAY, July 20, 2022 (HealthDay News) — Surveillance of high-risk individuals may downstage pancreatic ductal adenocarcinoma (PDAC), according to a study published online June 15 in the Journal of Clinical Oncology.

Mohamad Dbouk, M.D., from the Sol Goldman Pancreatic Cancer Research Center at Johns Hopkins Medical Institutions in Baltimore, and colleagues reported pancreas surveillance outcomes for 1,461 high-risk individuals within the multicenter Cancer of Pancreas Screening-5 (CAPS-5) study, of whom 48.5 percent had a pathogenic variant in a PDAC-susceptibility gene.

The researchers found that 10 patients were diagnosed with PDAC, including one with metastatic PDAC diagnosed four years after dropping out of surveillance. Seven of the remaining nine patients (77.8 percent) had a stage I PDAC detected during surveillance; and one each had stage II and stage III disease. Of the nine patients with PDAC, seven were alive after a median follow-up of 2.6 years. An additional eight patients underwent surgical resection for lesions of concern: three and five had high- and low-grade dysplasia in their resected specimens, respectively. Among 1,731 patients in the entire CAPS cohort (CAPS 1 to 5 studies), 26 cases of PDAC were diagnosed: 19 within surveillance, including 57.9 and 5.2 percent with stage I and stage IV disease, respectively. In contrast, six of seven PDACs (85.7 percent) detected outside of surveillance were stage IV. For patients with screen-detected PDAC, five-year survival to date was 73.3 percent, and median survival was 9.8 years compared with 1.5 years for those with PDAC detected outside of surveillance.

“Our results support the CAPS surveillance recommendation that those who meet the criteria should undergo regular screenings,” a coauthor said in a statement.

Several authors disclosed financial ties to the biopharmaceutical industry.

Abstract/Full Text