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Saudi J Gastroenterol. 2019 May 9. doi: 10.4103/sjg.SJG_56_19. [Epub ahead of print]

Development of pancreatic cancer during observation for hepatocellular carcinoma: A retrospective cohort study.

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Department of Radiology, Graduate School of Medicine, The University of Tokyo, Japan.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan.
Department of Radiology, The University of Tokyo Hospital, Japan.
Section of Radiation Biology, Center for Disease Biology and Integrative Medicine, Faculty of Medicine, The University of Tokyo, Japan.



We aimed to investigate incidence, characteristics, and possible risk factors of pancreatic cancer in patients under observation for hepatocellular carcinoma (HCC) because the association of hepatitis virus B infection and pancreatic cancer has been reported.

Patients and Methods:

We performed a retrospective cohort study in the Gastroenterology Department of a University Hospital in Japan between 2004 and 2012. A total of 1848 patients who underwent treatment for HCC were included at the initiation of treatment for HCC (mean follow-up period, 33.6 months). The patients received trimonthly radiological follow-ups. Newly developed cases of pancreatic cancer during follow-up for HCC were compared with that of an age- and sex-matched theoretical cohort from national statistics. Possible predisposing factors for pancreatic cancer related to HCC were assessed. Cumulative probabilities of developing a pancreatic cancer were compared using log-rank test.


About 13 of 1848 patients developed pancreatic cancer (mean follow-up period, 45.2 months). The risk ratio for all patients was 3.02 (log-rank test: P =0.01). Statistical analyses showed no effects of the following factors on the development of pancreatic cancer: age, sex, follow-up period, alcohol intake, laboratory data, presence of hepatitis virus, characteristics of HCC, type of treatment, number of radiological examinations, and cumulative effective dose.


Increased incidence of pancreatic cancer was found in patients under observation for HCC in a relatively small cohort. HCC or other common underlying conditions might be a risk factor for development of pancreatic cancer.


Hepatitis virus; liver cirrhosis; metachronous cancer; pancreas; radiation-induced cancer; synchronous cancer

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