title: Pancreatic ductal adenocarcinoma presenting with acute and chronic pancreatitis as initial presentation: is prognosis better? A comparison study..
abstract: BACKGROUND
  Pancreatic ductal adenocarcinoma (PDAC) may present with acute and /or chronic pancreatitis due to pancreatic ductal obstruction causing diagnostic dilemma. The aim of this retrospective study was to investigate the outcome and prognosis of the patients of PDAC presenting with pancreatitis.
  
  
  METHODS
  From 1991 to 2009, 298 patients with PDAC that underwent surgical treatment were retrospectively studied and divided in two groups depending upon initial symptomatic presentation. Group A (n=254) comprised patients without pancreatitis while group B (n=44) patients presented with acute and/or chronic pancreatitis initially.
  
  
  RESULTS
  All the patients in studied cohort were surgically treated. Mean age of group A was 63.1 years & for group B it was 62.9 years. Location of tumor was in head of the pancreas in 66.14% of group A patients (n=168) and 61.36% of group B patients (n=27). Although statistically insignificant, the patients in group B had overall better 5-year survival than the patients in group A (20% vs 15.9%).
  
  
  CONCLUSIONS
  This retrospective study highlights the overall better survival of PDAC patients presenting with acute and/or chronic pancreatitis than those without as contrary to previous reports which stated the poor prognosis of PDAC patients if associated with underlying pancreatitis.
authors.forename: Ashok
authors.initials: A
authors.lastname: Thorat
authors.forename: Wen-Hsuan
authors.initials: WH
authors.lastname: Huang
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Yeh
authors.forename: Yi-Yan
authors.initials: YY
authors.lastname: Jan
authors.forename: Tsann-Long
authors.initials: TL
authors.lastname: Hwang
mesh_terms: D000208:Acute Disease; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome