Progression to Pancreatic Ductal Adenocarcinoma from Pancreatic Intraepithelial Neoplasia: Results of a Simulation Model

Overview

Journal Pancreatology

Specialties Endocrinology
Gastroenterology

Date 2018 Aug 26

PMID 30143405

Citations 23

Authors

Mary Linton B Peters

Andrew Eckel

Peter P Mueller

Angela C Tramontano

Davis T Weaver

Anna Lietz

Chin Hur

Chung Yin Kong

Pari V Pandharipande

Affiliations

Soon will be listed here.

Abstract

Objectives: To gain insight into the natural history and carcinogenesis pathway of Pancreatic Intraepithelial Neoplasia (PanIN) lesions by building a calibrated simulation model of PanIN progression to pancreatic ductal adenocarcinoma (PDAC) METHODS: We revised a previously validated simulation model of solid PDAC, calibrating the model to fit data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program and published literature on PanIN prevalence by age. We estimated the likelihood of progression from PanIN states (1, 2, and 3) to PDAC and the time between PanIN onset and PDAC (dwell time). We evaluated a hypothetical intervention to test for and treat PanIN 3 lesions to estimate the potential benefits from PanIN detection.

Results: We estimated the lifetime probability of progressing from PanIN 1 to PDAC to be 1.5% (men), 1.3% (women). Progression from PanIN 1 to PDAC took 33.6 years and 35.3 years, respectively, and from PanIN 3 to PDAC took 11.3 years and 12.3 years. A hypothetical test for PanIN 3 detection and treatment could provide a maximum, average life expectancy gain of 40 days.

Conclusions: Our modeling analysis estimates PanINs have a relatively indolent course to PDAC, supporting the feasibility of potential future early detection strategies.

Citing Articles

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