Pancreatic cancer in patients with autoimmune pancreatitis: A scoping review.

Peter Macinga, Lukas Bajer, Marco Del Chiaro, Suresh T Chari, Petr Dite, Luca Frulloni, Tsukasa Ikeura, Terumi Kamisawa, Kensuke Kubota, Itaru Naitoh, Kazuichi Okazaki, Raffaele Pezzilli, Miroslav Vujasinovic, Julius Spicak, Tomas Hucl, Matthias Lӧhr

Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2022;21(5):928-937

PMID: 33775564

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Chronic pancreatitis is a known risk factor of pancreatic cancer (PDAC). A similar association has been suggested but not demonstrated for autoimmune pancreatitis (AIP).

OBJECTIVE

The aim of our study was to identify and analyse all published cases of AIP and PDAC co-occurrence, focusing on the interval between the diagnoses and the cancer site within the pancreas.

METHODS

Relevant studies were identified through automatic searches of the MEDLINE, EMBASE, Scopus, and Web of Science databases, and supplemented by manual checks of reference lists in all retrieved articles. Missing/unpublished data were obtained from the authors of relevant publications in the form of pre-prepared questionnaires.

RESULTS

A total of 45 cases of PDAC in AIP patients were identified, of which 12 were excluded from the analysis due to suspicions of duplicity or lack of sufficient data. Thirty-one patients (94%) had type 1 AIP. Synchronous occurrence of PDAC and AIP was reported in 11 patients (33%), metachronous in 22 patients (67%). In the metachronous group, the median period between diagnoses was 66.5 months (2-186) and a majority of cancers (86%) occurred more than two years after AIP diagnosis. In most patients (70%), the cancer originated in the part of the pancreas affected by AIP.

CONCLUSIONS

In the literature, there are reports on numerous cases of PDAC in AIP patients. PDAC is more frequent in AIP type 1 patients, typically metachronous in character, and generally found in the part of the pancreas affected by AIP.

Address: Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.; Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.; Clinic of Internal Medicine, University Hospital Ostrava, Ostrava, Czech Republic.; Gastroenterology Unit, Pancreas Center, University of Verona, Verona, Italy.; Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.; Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.; Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.; Department of Gastroenterology, San Carlo Hospital, Potenza, Italy.; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden; Department for Upper Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.; Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Electronic address: [email protected].; CLINTEC, Karolinska Institute, Stockholm, Sweden; Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.

DOI: 10.1016/j.pan.2021.03.007