Patients with Chronic Liver Disease under Surveillance for Hepatocellular Carcinoma Have a Favorable Long-Term Outcome for Pancreatic Cancer Due to Early Diagnosis and High Resection Rate

SIMPLE SUMMARY: Patients with pancreatic cancer are often diagnosed at an advanced stage. However, the incidental detection of pancreatic duct dilatation during surveillance for hepatocellular carcinoma often leads to the early diagnosis of pancreatic cancer in patients with viral hepatitis-related chronic liver disease. While pancreatic cancer can be diagnosed early, patients may have advanced chronic liver disease that precludes surgical resection, and the long-term prognosis is unknown for these patients. This study aimed to determine the long-term prognosis of pancreatic cancer patients with viral hepatitis-related chronic liver disease. We found that patients with viral hepatitis-related chronic liver disease under surveillance for hepatocellular carcinoma have a favorable long-term outcome for pancreatic cancer due to earlier diagnosis at earlier stages when resection is more feasible. ABSTRACT: Patients with viral hepatitis-related chronic liver disease (CLD) under surveillance for hepatocellular carcinoma (HCC) are often diagnosed with pancreatic cancer (PC) at an early stage. However, the long-term outcomes of these patients are unclear. We aimed to clarify the long-term outcomes of patients with PC with viral hepatitis-related CLD using a chart review. Data collection included the Union for International Cancer Control (UICC) stage at PC diagnosis, hepatitis B virus and hepatitis C virus status, and long-term outcomes. The distribution of the entire cohort (N = 552) was as follows: early stage (UICC 0-IB; n = 52, 9.5%) and non-early stages (UICC IIA-IV; n = 500, 90.5%). At diagnosis, the HCC surveillance group (n = 18) had more patients in the early stages than the non-surveillance group (n = 534) (50% vs. 8.0%), leading to a higher indication rate for surgical resection (72.2% vs. 29.8%) and a longer median survival time (19.0 months vs. 9.9 months). We confirmed that patients with viral hepatitis-related CLD under HCC surveillance were diagnosed with PC at an early stage. Because of the higher indication rate for surgical resection in these patients, they had favorable long-term outcomes for PC.