Open AccessResults of surveillance in individuals at high‐risk of pancreatic cancer: A systematic review and meta‐analysis
Author(s) -
Signoretti Marianna,
Bruno Marco J,
Zerboni Giulia,
Poley Jan-Werner,
Delle Fave Gianfranco,
Capurso Gabriele
Publication year - 2018
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640617752182
Subject(s) - medicine , pancreatic cancer , meta analysis , magnetic resonance imaging , radiology , oncology , cancer
Background Data on surveillance for pancreatic ductal adenocarcinoma (PDAC) in high‐risk individuals (HRIs) with “familial pancreatic cancer” (FPC) and specific syndromes are limited and heterogeneous. Objective We conducted a systematic review and meta‐analysis of PDAC surveillance studies in HRIs. Methods Prevalence of solid/cystic pancreatic lesions and of lesions considered a successful target of surveillance (proven resectable PDAC and high‐grade precursors) was pooled across studies. The rate of lesions diagnosed by endoscopic ultrasonography (EUS)/magnetic resonance imaging (MRI) and across different HRI groups was calculated. Results Sixteen studies incorporating 1588 HRIs were included. The pooled prevalence of pancreatic solid and cystic lesions was 5.8% and 20.2%, respectively. The pooled prevalence of patients with lesions considered a successful target of surveillance was 3.3%, being similar to EUS or MRI and varying across subgroups, being 3% in FPC, 4% in hereditary pancreatitis, 5% in familial melanoma, 6.3% in hereditary breast/ovarian cancer, and 12.2% in Peutz‐Jeghers syndrome. The pooled estimated rate of lesions considered a successful target of surveillance during follow‐up was 5/1000 person‐years. Conclusion Surveillance programs identify successful target lesions in 3.3% of HRIs with a similar yield of EUS and MRI and an annual risk of 0.5%. A higher rate of target lesions was reported in HRIs with specific DNA mutations.