title: Extrapancreatic malignancies in patients with pancreatic cancer: epidemiology and clinical consequences.
abstract: OBJECTIVE
  To investigate the incidence, characteristics, and prognostic impact of prior extrapancreatic malignancies on patients with pancreatic cancer (PDAC).
  
  
  METHODS
  Records from 1733 patients who underwent surgery for PDAC were analyzed for the occurrence of prior extrapancreatic malignancies. Patients' records showing extrapancreatic malignancies were then analyzed for tumor type, epidemiological data, risk factors, PDAC tumor stage, and long-term survival.
  
  
  RESULTS
  A total of 239 patients with PDAC (13.8%) had a history of 271 extrapancreatic tumors; 26 patients had a history of two pancreatic cancers, and 3 patients had 3 extrapancreatic cancers. The most common extrapancreatic tumors were breast cancer (56 patients) and prostate cancer (41 patients), followed by colorectal, reno/urothelial, and gynecologic tumors (39, 32, and 23 patients, respectively). No significant difference in overall survival was found between patients with PDAC with or without extrapancreatic malignancies.
  
  
  CONCLUSIONS
  Pancreatic cancer is associated with extrapancreatic malignancies in a remarkable number of patients. A history of extrapancreatic malignancies does not influence prognosis and should not be an obstacle to a curative therapeutic approach. Surveillance of patients with extrapancreatic malignancies, especially breast, prostate, and colorectal cancer, could allow for earlier PDAC diagnosis and therefore improve prognosis of these patients.
authors.affiliation: Department of Surgery, University of Heidelberg, Heidelberg, Germany. Thilo_Hackert@med.uni-heidelberg.de
authors.forename: Thilo
authors.initials: T
authors.lastname: Hackert
authors.forename: Christin
authors.initials: C
authors.lastname: Tjaden
authors.forename: Sascha
authors.initials: S
authors.lastname: Müller
authors.forename: Ulf
authors.initials: U
authors.lastname: Hinz
authors.forename: Werner
authors.initials: W
authors.lastname: Hartwig
authors.forename: Oliver
authors.initials: O
authors.lastname: Strobel
authors.forename: Stefan
authors.initials: S
authors.lastname: Fritz
authors.forename: Bruno
authors.initials: B
authors.lastname: Schmied
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors