title: Pancreatitis before pancreatic cancer: clinical features and influence on outcome.
abstract: OBJECTIVE
  Pancreatitis is considered a possible risk factor for and a presentation of pancreatic adenocarcinoma (PA). We aimed to evaluate a large PA patient registry to determine whether prior history of pancreatitis influenced survival.
  
  
  METHODS
  We retrospectively analyzed the Mayo Clinic Biospecimen Resource for Pancreas Research database from January 1992 to September 2011. Data collected included demographic characteristics, history of tobacco or alcohol use, diabetes mellitus (DM), cholelithiasis, pseudocyst, and details regarding PA. Clinical characteristics and outcomes of PA patients with pancreatitis were compared with PA patients without pancreatitis history.
  
  
  RESULTS
  We analyzed 2573 patients with PA diagnosis. Among these patients, 195 (8%) were identified who had pancreatitis diagnosis ≥ 10 days before PA diagnosis. The cohort with pancreatitis history included more patients with DM (30% vs. 18%; P<0.001) and more smokers (68% vs. 58%; P=0.02). Compared with patients without pancreatitis history, these patients received diagnoses of PA at a younger age (63 vs. 65 y; P=0.005) and earlier stage (stages I and II; 52% vs. 37%; P<0.001). A greater percentage had history of surgery with curative intent (50% vs. 43%; P=0.001) and significantly better survival [median (range), 387 d (314 to 460 d) vs. 325 d (306 to 344 d); P=0.003].
  
  
  CONCLUSIONS
  Patients with PA and pancreatitis had more weight loss and DM, but had PA diagnosis at an earlier stage, were more likely to have pancreatic surgery, and therefore better survival than PA patients without pancreatitis, likely due to the earlier diagnosis. Further studies are needed to evaluate whether screening for PA in patients with pancreatitis history would provide survival benefit.
authors.affiliation: Divisions of *Gastroenterology †Hepatology ‡Health Sciences Research, Mayo Clinic, Scottsdale, AZ.
authors.forename: Ivana
authors.initials: I
authors.lastname: Dzeletovic
authors.forename: M Edwyn
authors.initials: ME
authors.lastname: Harrison
authors.forename: Michael D
authors.initials: MD
authors.lastname: Crowell
authors.forename: Rahul
authors.initials: R
authors.lastname: Pannala
authors.forename: Cuong C
authors.initials: CC
authors.lastname: Nguyen
authors.forename: Qing
authors.initials: Q
authors.lastname: Wu
authors.forename: Douglas O
authors.initials: DO
authors.lastname: Faigel
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D000368:Aged; D001130:Arizona; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis