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Magnetic Resonance Imaging Surveillance Detects Early-Stage Pancreatic Cancer in Carriers of a p16-Leiden Mutation
Abstract
Background & aims Surveillance of high-risk groups for pancreatic cancer might increase early detection and treatment outcomes. Individuals with germline mutations in p16-Leiden have a lifetime risk of 15% to 20% of developing pancreatic cancer. We assessed the feasibility of detecting pancreatic cancer at an early stage and investigated the outcomes of patients with neoplastic lesions.Methods Individuals with germline mutations in p16-Leiden (N = 79; 31 male; mean age, 56 years; range, 39-72 years) were offered annual surveillance by magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP). Those found to have neoplastic lesions were offered options for surgery or intensive follow-up. Individuals found to have possible neoplastic lesions were examined again by MRI/MRCP within 2 to 4 months.Results After a median follow-up period of 4 years (range, 0-10 years), pancreatic cancer was diagnosed in 7 patients (9%). The mean age at diagnosis was 59 years (range, 49-72 years). Three of the tumors were present at the first examination, and 4 were detected after a negative result in the initial examination. All 7 patients had a resectable lesion; 5 underwent surgery, 3 had an R0 resection, and 2 had lymph node metastases. Possible precursor lesions (ie, duct ectasias, based on MRCP) were found in 9 individuals (11%).Conclusions MRI/MRCP detects small, solid pancreatic tumors and small duct ectasias. Although surveillance increases the rate of resectability, carriers of a p16-Leiden mutation develop aggressive tumors.
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“The CAPS5 study results differ in some respects from the recent report of the Dutch Familial Pancreatic Cancer Surveillance Study Group.16 This study reported a PDAC resectability rate of only 60%, which may be a function of the predominance of CDKN2A mutation carriers in their high-risk cohort”
From The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival (2022) · cites this paper as [24]
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Metadata
- Authors
- Vasen, H. F. A., Wasser, M., van Mil, A., Tollenaar, R. A., Konstantinovski, M., Gruis, N. A., Bergman, W., Hes, F. J., Hommes, D. W., Offerhaus, G. J. A., Morreau, H., Bonsing, B. A., & de Vos tot Nederveen Cappel, W. H.
- Affiliations
- Leiden University Medical Center (NL)
- University Medical Center Utrecht (NL)
- Corresponding author
- Vasen, Hans F.A.
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 140
- Issue
- 3
- Pages
- 850-856
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2066851924
- Cited by
- 152
- References
- 19
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 7 · 2023: 3 · 2022: 10 · 2021: 5 · 2020: 7 · 2019: 11 · 2018: 13 · 2017: 11 · 2016: 14 · 2015: 16 · 2014: 17 · 2013: 9 · 2012: 19
- FWCI
- 5.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Keywords
- pancreatic cancer, germline mutation carriers, cancer surveillance, early detection, magnetic resonance imaging, magnetic resonance cholangiopancreatography, duct ectasia, tumor resectability, lymph node metastasis
- MeSH terms
- Adenocarcinoma, Adult, Aged, Feasibility Studies, Female, Humans, Magnetic Resonance Imaging, Male, Mass Screening, Middle Aged, Neoplasm Staging, Netherlands, Pancreas, Pancreatic Neoplasms, Phenotype, Precancerous Conditions, Predictive Value of Tests, Prognosis, Registries, Time Factors, Germ-Line Mutation, Genes, p16, Genetic Predisposition to Disease, Cholangiopancreatography, Magnetic Resonance, Early Detection of Cancer
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