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Clinical outcomes and prevalence of cancer in patients with possible groove pancreatitis
Author(s) -
Lekkerkerker Selma J,
Nio Chung Y,
Issa Yama,
Fockens Paul,
Verheij Joanne,
Busch Olivier R,
Gulik Thomas M,
Rauws Erik A,
Boermeester Marja A,
Hooft Jeanin E,
Besselink Marc G
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13376
Subject(s) - medicine , malignancy , pancreatic cancer , cancer , pancreatitis , jaundice , surgery , retrospective cohort study
Background and Aim Data on non‐surgical treatment of groove pancreatitis (GP) and the risk of cancer are lacking. We aimed to determine the prevalence and predictors of cancer in patients in whom the diagnosis GP was considered, and to evaluate symptom improvement after treatment. Study Patients referred with possible GP (2001–2014) were retrospectively included. An experienced radiologist reassessed imaging. GP patients received questionnaires evaluating their symptoms. Results From the 38 possible GP patients, 10 had cancer (26%) and 28 GP (74%). Compared with cancer patients, GP patients more frequently had cysts (2/10 vs. 18/28, P = 0.03), less often jaundice (6/10 vs 3/27, P < 0.01), an abrupt caliber change of the CBD (5/10 vs. 2/28, P < 0.01) or suspicious cytology (5/9 vs 2/20, P = 0.02). Of the 28 GP patients, 14 patients were treated conservatively of whom 12 reported symptom improvement after a median follow‐up of 45 months (range 7–127 months). All 6 patients treated endoscopically and 7/8 patients treated surgically reported symptom improvement. Surgery, performed because of treatment failure (3/8) or inability to exclude malignancy (5/8), caused mortality in 1/8 patients. Conclusions Suspicion of pancreatic cancer should be high in patients presenting with possible GP. Conservative, endoscopic and surgical treatment can all lead to symptom improvement, suggesting a ‘step‐up approach’ to GP once cancer is excluded.