title: Clinical outcomes and prevalence of cancer in patients with possible groove pancreatitis.
abstract: OBJECTIVE
  Data on non-surgical treatment of groove pancreatitis (GP) and the risk of cancer are lacking. We aimed to determine the prevalence and predictors of cancer in patients in whom the diagnosis GP was considered, and to evaluate symptom improvement after treatment.
  
  
  METHODS
  Patients referred with possible GP (2001-2014) were retrospectively included. An experienced radiologist reassessed imaging. GP patients received questionnaires evaluating their symptoms.
  
  
  RESULTS
  From the 38 possible GP patients, 10 had cancer (26%) and 28 GP (74%). Compared with cancer patients, GP patients more frequently had cysts (2/10 vs. 18/28, P = 0.03), less often jaundice (6/10 vs 3/27, P < 0.01), an abrupt caliber change of the CBD (5/10 vs. 2/28, P < 0.01) or suspicious cytology (5/9 vs 2/20, P = 0.02). Of the 28 GP patients, 14 patients were treated conservatively of whom 12 reported symptom improvement after a median follow-up of 45 months (range 7-127 months). All 6 patients treated endoscopically and 7/8 patients treated surgically reported symptom improvement. Surgery, performed because of treatment failure (3/8) or inability to exclude malignancy (5/8), caused mortality in 1/8 patients.
  
  
  CONCLUSIONS
  Suspicion of pancreatic cancer should be high in patients presenting with possible GP. Conservative, endoscopic and surgical treatment can all lead to symptom improvement, suggesting a 'step-up approach' to GP once cancer is excluded.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Selma J
authors.initials: SJ
authors.lastname: Lekkerkerker
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Chung Y
authors.initials: CY
authors.lastname: Nio
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Yama
authors.initials: Y
authors.lastname: Issa
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.affiliation: Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Joanne
authors.initials: J
authors.lastname: Verheij
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Olivier R
authors.initials: OR
authors.lastname: Busch
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Rauws
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Marja A
authors.initials: MA
authors.lastname: Boermeester
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Jeanin E
authors.initials: JE
authors.lastname: van Hooft
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Besselink
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology*; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: pancreatic cancer; pancreatitis; treatment outcome