BACKGROUND: Peptic ulcer surgery may carry an increased risk for pancreatic cancer development. Molecular analysis of K-ras codon 12, frequently mutated in conventional pancreatic cancers, might provide insight into the aetiological mechanisms. METHODS: The relative risk of pancreatic cancer was computed by multivariate and person-year analysis in a cohort of 2633 patients who had undergone gastrectomy. Lung cancer risk was analysed as an indirect means of assessing smoking behaviour. K-ras codon 12 mutational analysis was performed on 15 postgastrectomy pancreatic cancers. RESULTS: There was an overall increased risk of pancreatic carcinoma of 1.8 (95% confidence interval, 1.3 to 2.6) five to 59 years postoperatively, which gradually increased to 3.6 at 35 years or more after surgery (chi(2) test for trend, p < 0.05). Multivariate analysis indicated that parameters other than postoperative interval did not influence the risk. Lung cancer risk was significantly increased after surgery, but no time trend was observed. The spectrum and prevalence of K-ras codon 12 mutations were comparable to conventional pancreatic cancer. CONCLUSIONS: Remote partial gastrectomy is associated with an increased risk of pancreatic cancer. Postgastrectomy and non-postgastrectomy pancreatic cancers may share similar aetiological factors, such as smoking. However, the neoplastic process in patients who have undergone gastrectomy appears to be accelerated by factors related to the surgery itself.
BACKGROUND: Peptic ulcer surgery may carry an increased risk for pancreatic cancer development. Molecular analysis of K-ras codon 12, frequently mutated in conventional pancreatic cancers, might provide insight into the aetiological mechanisms. METHODS: The relative risk of pancreatic cancer was computed by multivariate and person-year analysis in a cohort of 2633 patients who had undergone gastrectomy. Lung cancer risk was analysed as an indirect means of assessing smoking behaviour. K-ras codon 12 mutational analysis was performed on 15 postgastrectomy pancreatic cancers. RESULTS: There was an overall increased risk of pancreatic carcinoma of 1.8 (95% confidence interval, 1.3 to 2.6) five to 59 years postoperatively, which gradually increased to 3.6 at 35 years or more after surgery (chi(2) test for trend, p < 0.05). Multivariate analysis indicated that parameters other than postoperative interval did not influence the risk. Lung cancer risk was significantly increased after surgery, but no time trend was observed. The spectrum and prevalence of K-ras codon 12 mutations were comparable to conventional pancreatic cancer. CONCLUSIONS: Remote partial gastrectomy is associated with an increased risk of pancreatic cancer. Postgastrectomy and non-postgastrectomy pancreatic cancers may share similar aetiological factors, such as smoking. However, the neoplastic process in patients who have undergone gastrectomy appears to be accelerated by factors related to the surgery itself.
Authors: C H Chung; R E Wilentz; M M Polak; T B Ramsoekh; L A Noorduyn; D J Gouma; K Huibregtse; G J Offerhaus; R J Slebos Journal: J Clin Pathol Date: 1996-06 Impact factor: 3.411
Authors: R H Hruban; A D van Mansfeld; G J Offerhaus; D H van Weering; D C Allison; S N Goodman; T W Kensler; K K Bose; J L Cameron; J L Bos Journal: Am J Pathol Date: 1993-08 Impact factor: 4.307
Authors: J Galceran; A Ameijide; M Carulla; A Mateos; J R Quirós; D Rojas; A Alemán; A Torrella; M Chico; M Vicente; J M Díaz; N Larrañaga; R Marcos-Gragera; M J Sánchez; J Perucha; P Franch; C Navarro; E Ardanaz; J Bigorra; P Rodrigo; R Peris Bonet Journal: Clin Transl Oncol Date: 2017-01-16 Impact factor: 3.405
Authors: C Bosetti; E Lucenteforte; P M Bracci; E Negri; R E Neale; H A Risch; S H Olson; S Gallinger; A B Miller; H B Bueno-de-Mesquita; R Talamini; J Polesel; P Ghadirian; P A Baghurst; W Zatonski; E Fontham; E A Holly; Y T Gao; H Yu; R C Kurtz; M Cotterchio; P Maisonneuve; M P Zeegers; E J Duell; P Boffetta; C La Vecchia Journal: Ann Oncol Date: 2013-08-22 Impact factor: 32.976