Skip to main content

Advertisement

SpringerLink
Log in

Poor prognosis of common-type invasive ductal carcinomas that originate in the branching pancreatic duct

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To clarify the incidence, clinicopathological features and prognosis of pancreatic invasive ductal carcinomas (IDCs) with different tumor origin sites in the pancreatic duct.

Methods

Based on the relationship between the invasive cancer area (ICA) and the main pancreatic duct (MPD), IDCs less than 2 cm in diameter were classified into two groups: type I, in which the ICA and MPD were separated, and type II, in which the MPD passed through the ICA. The clinicopathological findings and prognosis of each type were compared in a total of 37 patients.

Results

The incidences of IDC types I and II were 18.9 and 81.1 %, respectively. Although there was no difference in local invasion, both node involvement and venous invasion tended to occur more frequently in type I IDC, and the three-year survival rate was significantly lower for type I (28.6 %) than type II (71.8 %) IDC.

Conclusions

The prognosis of IDCs that originated in the branching pancreatic duct (BPD) distant from the MPD (type I) was worse than the prognosis of IDCs that originated in either the MPD or the BPD close to the MPD (type II). These data suggest that the progression and degree of malignancy of IDCs may vary depending on the site of tumor origin in the pancreatic duct.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jung KW, Kim MH, Lee TY, Kwon S, Oh HC, Lee SS, et al. Clinicopathological aspects of 542 cases of pancreatic cancer: a special emphasis on small pancreatic cancer. J Korean Med Sci. 2007;22(Suppl):S79–85.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Shimizu Y, Yasui K, Matsueda K, Yanagisawa A, Yamao K. Small carcinoma of the pancreas is curable: new computed tomography finding, pathological study and postoperative results from a single institute. J Gastroenterol Hepatol. 2005;20:1591–4.

    Article  PubMed  Google Scholar 

  3. Egawa S, Takeda K, Fukuyama S, Motoi F, Sunamura M, Matsuno S. Clinicopathological aspects of small pancreatic cancer. Pancreas. 2004;28:235–40.

    Article  PubMed  Google Scholar 

  4. Suda K, Nobukawa B, Yamasaki S, Abe K, Matsukuma S, Suzuki F. Invasive ductal adenocarcinoma of the pancreas may originate from the larger pancreatic duct: a study of 13 tumors less than 2 cm in diameter. J Hepatobiliary Pancreat Surg. 2007;14:283–8.

    Article  PubMed  Google Scholar 

  5. Pour PM, Sayed S, Sayed G. Hyperplastic, preneoplastic and neoplastic lesions found in 83 human pancreases. Am J Clin Pathol. 1982;77:137–52.

    CAS  PubMed  Google Scholar 

  6. Hisa T, Suda K, Nobukawa B, Ohkubo H, Shiozawa S, Ishigame H, et al. Distribution of intraductal lesions in small invasive ductal carcinoma of the pancreas. Pancreatology. 2007;7:341–6.

    Article  PubMed  Google Scholar 

  7. Yamasaki S, Suda K, Nobukawa B, Sonoue H. Intraductal spread of pancreatic cancer. Clinicopathologic study of 54 pancreatectomized patients. Pancreatology. 2002;2:407–12.

    Article  PubMed  Google Scholar 

  8. Ikeda M, Yanagisawa A, Seki M, Sasaki K, Takano K, Kato Y. The early state of invasive pancreatic ductal adenocarcinomas: characteristics of the low papillary type and flat type intraductal carcinoma. Pancreas. 2006;33:135–41.

    Article  PubMed  Google Scholar 

  9. Chiang KC, Yeh CN, Lee WC, Jan YY, Hwang TL. Prognostic analysis of patients with pancreatic head adenocarcinoma less than 2 cm undergoing resection. World J Gastroenterol. 2009;15:4305–10.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Takeshita K, Kutomi K, Haruyama T, Watanabe A, Furui S, Fukushima J, et al. Imaging of early pancreatic cancer on multidetector row helical computed tomography. Br J Radiol. 2010;83:823–30.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Ikeda S, Maeshiro K, Ryu S, Ogata K, Yasunami Y, Nakayama Y, et al. Diagnosis of small pancreatic cancer by endoscopic balloon-catheter spot pancreatography: an analysis of 29 patients. Pancreas. 2009;38:e102–13.

    Article  PubMed  Google Scholar 

  12. Ishikawa O, Ohigashi H, Imaoka S, Nakaizumi A, Uehara H, Kitamura T, et al. Minute carcinoma of the pancreas measuring 1 cm or less in diameter—collective review of Japanese case reports. Hepatogastroenterology. 1999;46:8–15.

    CAS  PubMed  Google Scholar 

  13. Sobin HL, Gospodarowicz KM, Wittekind C. TNM Classification of malignant tumors. 7th ed. NY: Wiley-Liss Inc; 2009.

    Google Scholar 

  14. Klöppel G, Hruban RH, Longnecker DS, Adler G, Kern SE, Partanen TJ. World Health Organization classification of tumors, pathology and genetics of the digestive system. In: Hamilton SR, Aaltonen LA, editors. World Health Organization classification of tumors, pathology and genetics of the digestive system. Lyon: IARC Press; 2000. p. 221–30.

    Google Scholar 

  15. Japan Pancreatic Society. Classification of pancreatic carcinoma. 2nd English ed. Tokyo: Kanehara; 2003.

  16. Hruban RH, Takaori K, Klimstra DS, Adsay NV, Albores-Saavedra J, Biankin AV, et al. An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol. 2004;28:977–87.

    Article  PubMed  Google Scholar 

  17. Kobari M, Egawa S, Shibuya K, Shimamura H, Sunamura M, Takeda K, et al. Intraductal papillary mucinous tumors of the pancreas comprise 2 clinical subtypes: differences in clinical characteristics and surgical management. Arch Surg. 1999;134:1131–6.

    Article  CAS  PubMed  Google Scholar 

  18. Terris B, Ponsot P, Paye F, Hammel P, Sauvanet A, Molas G, et al. Intraductal papillary mucinous tumors of the pancreas confined to secondary ducts show less aggressive pathologic features as compared with those involving the main pancreatic duct. Am J Surg Pathol. 2000;24:1372–7.

    Article  CAS  PubMed  Google Scholar 

  19. Furuta K, Watanabe H, Ikeda S. Differences between solid and duct-ectatic types of pancreatic ductal carcinomas. Cancer. 1992;69:1327–33.

    Article  CAS  PubMed  Google Scholar 

  20. Kanda M, Fujii T, Takami H, Suenaga M, Inokawa Y, Yamada S, et al. The combination of the serum carbohydrate antigen 19-9 and carcinoembryonic antigen is a simple and accurate predictor of mortality in pancreatic cancer patients. Surg Today. 2014;44:1692–701.

    Article  CAS  PubMed  Google Scholar 

  21. Ko¨nigsrainer I, Zieker D, Symons S, Horlacher K, Ko¨nigsrainer A, Beckert S. Do patient- and tumor-related factors predict the peritoneal spread of pancreatic adenocarcinoma? Surg Today. 2014;44:260–3.

    Article  Google Scholar 

  22. Franko J, Hugec V, Lopes T, Goldman C. Survival among pancreaticoduodenectomy patients treated for pancreatic head cancer <1 or 2 cm. Ann Surg Oncol. 2013;20:357–61.

    Article  PubMed  Google Scholar 

  23. Van den Broeck A, Sergeant G, Ectors N, Van Steenbergen W, Aerts R, Topal B. Patterns of recurrence after curative resection of pancreatic ductal adenocarcinoma. Eur J Surg Oncol. 2009;35:600–4.

    Article  PubMed  Google Scholar 

  24. Ishikawa O, Ohigashi H, Eguchi H, Sasaki Y, Yamada T, Imaoka S. Survival and late morbidity after resection of pancreatic cancer. In: Beger HG, Warshaw AL, Buchler MW, Kozarek RA, editors. The pancreas: an integrated textbook of basic science, medicine, and surgery. Malden: Blackwell Publishing Ltd; 2008. p. 776–84.

    Chapter  Google Scholar 

  25. Sperti C, Pasquali C, Piccoli A, Pedrazzoli S. Recurrence after resection for ductal adenocarcinoma of the pancreas. World J Surg. 1997;21:195–200.

    Article  CAS  PubMed  Google Scholar 

  26. Rhim A, Mirek E, Aiello N, Maitra A, Bailey A, McCallister F, et al. EMT and dissemination precede pancreatic tumor formation. Cell. 2012;148:349–61.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Furukawa K, Uwagawa T, Haruki K, Fujiwara Y, Iida T, Shiba H, et al. Nuclear factor kB activity correlates with the progression and prognosis of pancreatic cancer in a mouse model. Surg Today. 2013;43:171–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan

    Masataka Ando, Yasuhiro Shimizu, Tsuyoshi Sano, Yoshiki Senda & Yuji Nimura

  2. Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan

    Kenji Yamao

  3. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan

    Masato Nagino

  4. Department of Pathology, Kyoto Prefectural Medical University Graduate School of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Akio Yanagisawa

Authors
  1. Masataka Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuhiro Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tsuyoshi Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshiki Senda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuji Nimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kenji Yamao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masato Nagino
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akio Yanagisawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akio Yanagisawa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ando, M., Shimizu, Y., Sano, T. et al. Poor prognosis of common-type invasive ductal carcinomas that originate in the branching pancreatic duct. Surg Today 45, 1291–1298 (2015). https://doi.org/10.1007/s00595-014-1075-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-014-1075-1

Keywords

Search

Navigation