Table 1.
Characteristics of 48 Resected High Risk Individuals and Screening-Detected Lesions, Stratified by the Highest Grade of Pathologic Diagnosis At End of Follow-Up Period (including second operations)
| Pathology (n) |
Indication for Surgery (n) |
Median Age (years) / % Male |
Type of Operations (Number of Open/ Minimally Invasive) |
Median Tumor Size (cm) |
AJCC Stage for PDAC |
Median Follow- Up (years)/ % Alive |
Overall 1-Year Survival/ 5 year- Survival |
Cause of Death, where applicable (n) |
|---|---|---|---|---|---|---|---|---|
| PDAC (11) | Solid mass (8) Cyst with duct dilatation (1) Rapid cyst growth (2) |
65/54.6% | Whipple (6/0 ) a Distal (3/0) Total (2/0) |
2.7 (IQR 1.5-3.5) | Stage IA, T1N0M 0 (2) Stage IIA T3N0M 0 (2) Stage IIB, T2N1M 0 (4) Stage IIB, T3N1M 0 (2) Stage IV, T3N1M 1 after remote Whipple (1)a |
4.7/45.6 % | 90%/60% | PDAC-related(4), non-PDAC related(2) |
| High-grade PDAC precursors (10) | ||||||||
| IPMN HGD (6) c | Mass (1) Cyst with mural nodule (1) Cyst with main duct dilatation and mural nodules(1) Rapid cyst growth (3) |
66/16.7% | Whipple (2/0) Distal (3/1) |
1.6 (IQR 1.0-2.3) | Tis (including 2 combined IPMN) | 7.4/100% | 100%/100% | No death |
| PanIN-3 (4) | Cyst with main duct dilatation (1) Main PD stricture with dilation, no mass (1) Rapid cyst growth, multifocal cysts (2) |
66/0% | Whipple (2/0) b Total (2/0) |
1.2 (IQR 0.9-1.5) | Tis (including 1 main duct PanIN3) | 7.6/85.7% | 100%/100% | Non-PDAC related (1) at 7 years |
| Low-grade PDAC precursors (24): PanIN2, IPMN-LGD, IPMN-MGD | Mass (10) Cyst with duct dilatation (4) Rapid cyst growth (10) |
62/56% | Whipple (5/0) Distal (12/5) Total (1/1) |
1.6 (IQR 0.7-2.2) | NA | 8.4/96% | 100%/100% | Non-PDAC related (1) at 11.2 years |
| Pancreatic neuroendocrine tumor > 5 mm (4) | Mass with positive EUS-FNA cytology (4) | 51/100% | Whipple (2/0) c Distal (1/1) Total (0/0) |
1.2 (IQR 1-1.8) | Stage IIB, T3N1M0 (1) Stage 1A (3) |
8.4/100% | 100%/100% | No death |
Patient had a Whipple operation for a BD-IPMN with moderate dysplasia in the head, with main duct involvement (mild dysplasia) at the margin, and presented 5 years later with a metachronous unresectable pancreatic tail PDAC with liver metastases despite annual CT surveillance. Given no pancreatic resection at the time of PDAC diagnosis due to metastatic stage, this patient was excluded from further analyses.
IPMN HGD and PanIN3 at completion pancreatectomy after initial resection
Patient had a Whipple procedure for a pT3N1b NET, then developed a new pT1N0 PanNET in the remnant pancreatic tail, requiring completion distal pancreatectomy