BRCA and screening for pancreatic cancer – pro

M Levin, MD — Tue, 28 Aug 2012 18:22:08 +0000

Certain germline mutations are known to give rise to hereditary pancreatic cancer syndromes including BRCA2, p16,STK11/LKB1,and PRSS1. There are several other conditions that incrase the risk of pancreatic cacner but this post will focus on BRCA. BRCA2 is a key regulator of gene transcription.

Mutation in this gene results in hereditary breast and ovarian cancer syndromes. Over the last 10 years it has been noted that some families with BRCA2 mutations have a high incidence of pancreatic cancer. There may be some utility to Transesophageal Ultrasound. One retrospective report concluded that screening of high-risk individuals is warranted due to the number of significant asymptomatic pancreatic neoplastic lesions found in this cohort of individuals. To my knowledge, similar work has not been done with CT scans.

Teresa A. Brentnall MD

CANCER SURVEILLANCE OF PATIENTS FROM FAMILIAL PANCREATIC CANCER KINDREDS Medical Clinics of North America
Volume 84, Issue 3, 1 May 2000, Pages 707-718

Nccn.org, Pancreatic Cancer

http://www.moffitt.org/CCJRoot/v15n4/pdf/280.pdf

Readmission After Pancreaticodudenectomy – pro

M Levin, MD — Wed, 20 Jun 2012 19:53:20 +0000

The Whipple procedure is a complex and morbid up duration with significant readmission rates. In a recent review of experience at the Johns Hopkins, readmission rates have been decreasing. When early and late complications were compared, patients with early complications were likelier to be readmitted for delayed gastric emptying (12% vs. 4%; P<0.01), intra-abdominal abscess (17% vs. 4%; P<0.0001) and wound infections (6% vs.1%; P< 0.02). Conversely, the indication for those readmitted more than one year after surgery was more likely to be obstructive jaundice (17% vs. 4%; P<0.0001), metastatic disease (12% vs. 5%; P< 0.0001) or incisional hernias (12% vs. 3%; P<0.0001). Other reports show similar results.

Grewal SS, McClaine RJ, Schmulewitz N, Alzahrani MA, Hanseman DJ, Factors associated with recidivism following pancreaticoduodenectomy.HPB (Oxford). 2011 Dec;13(12):869-75.

Dawn M. Emick, Taylor S. Riall, John L. Cameron, Jordan M. Winter, Keith D. Lillemoe, JoAnn
Hospital readmission after pancreaticoduodenectomy Journal of Gastrointestinal Surgery
Volume 10, Number 9, 1243-1253, 2006

ZHU Zi-yi, HE Ji-kai, WANG Yi-fan, LIANG Xiao, YU Hong, WANG Xian-fa and CAI Xiu-junChin MedMultivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy
for malignant diseases J 2011;124(7):1022-1025

Read the Layperson version here.

Cancer Treatment Today » Surgery

BRCA and screening for pancreatic cancer – pro

Readmission After Pancreaticodudenectomy – pro