Fulton AJ, Lamarca A, Nuttall C, McCallum L, Pihlak R, O’Reilly D, Lalloo F, McNamara MG, Hubner RA, Clancy T, Valle JW. Identification of patients with pancreatic adenocarcinoma due to inheritable mutation: Challenges of daily clinical practice. World J Gastrointest Oncol 2019; 11(2): 102-116 [PMID: 30788038 DOI: 10.4251/wjgo.v11.i2.102]
Corresponding Author of This Article
Angela Lamarca, MD, MSc, PhD, Consultant Medical Oncologist / Honorary Senior Lecturer, Department of Medical Oncology, The Christie NHS Foundation Trust, Division of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester M20 4BX, United Kingdom. angela.lamarca@christie.nhs.uk
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Feb 15, 2019; 11(2): 102-116 Published online Feb 15, 2019. doi: 10.4251/wjgo.v11.i2.102
Identification of patients with pancreatic adenocarcinoma due to inheritable mutation: Challenges of daily clinical practice
Alexander JP Fulton, Angela Lamarca, Christina Nuttall, Lynne McCallum, Rille Pihlak, Derek O’Reilly, Fiona Lalloo, Mairéad G McNamara, Richard A Hubner, Tara Clancy, Juan W Valle
Alexander JP Fulton, Angela Lamarca, Christina Nuttall, Lynne McCallum, Rille Pihlak, Mairéad G McNamara, Richard A Hubner, Juan W Valle, Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester M204BX, United Kingdom
Derek O’Reilly, Hepato-pancreato-biliary Surgical Department, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, United Kingdom
Fiona Lalloo, Tara Clancy, Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Saint Mary's Hospital, Manchester M13 9WL, United Kingdom
Author contributions: Fulton AJ and Lamarca A contributed equally to this work; Valle JW and Lamarca A were involved in the project design; Fulton AJ, Lamarca A and Clancy T were involved in data collection and analysis; Fulton AJ and Lamarca A were involved in manuscript drafting; all authors were involved in result interpretation and were involved in final approval of manuscript.
Institutional review board statement: This work was approved by The Christie NHS Foundation Trust Audit Committee (CE15/1575).
Informed consent statement: Consent for images to be used for publication.
Conflict-of-interest statement: Authors have no conflict of interest to declare related to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Angela Lamarca, MD, MSc, PhD, Consultant Medical Oncologist / Honorary Senior Lecturer, Department of Medical Oncology, The Christie NHS Foundation Trust, Division of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester M20 4BX, United Kingdom. angela.lamarca@christie.nhs.uk
Telephone: +44-161-4468106 Fax: +44-161-4463468
Received: August 30, 2018 Peer-review started: August 30, 2018 First decision: October 26, 2018 Revised: December 6, 2018 Accepted: January 10, 2019 Article in press: January 10, 2019 Published online: February 15, 2019 Processing time: 170 Days and 1.3 Hours
Abstract
BACKGROUND
Identification of germ-line mutations in pancreatic ductal adenocarcinoma (PDAC) could impact on patient/family.
AIM
To assess the referral pathways for genetic consultations in PDAC.
METHODS
Electronic records of PDAC patients were reviewed retrospectively. Patients eligible for genetic consultation referral were identified following the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC) criteria.
RESULTS
Four-hundred patients were eligible. Of 113 patients (28.3%) meeting EUROPAC criteria, 8.8% were referred for genetic opinion. Germ-line mutations were identified in 0.75% of the whole population.
CONCLUSION
Earlier referrals and increased awareness may be able to overcome the low rate of successful genetic appointments.
Core tip: Electronic records of consecutive patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) were reviewed retrospectively. The European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC) criteria were employed to identify patients eligible for genetic consultation referral. Out of 400 eligible patients, 113 (28.3% of the whole population) met referral criteria, only 10 (8.8%) were referred for genetic opinion. There was a low referral rate even for patients fulfilling EUROPAC criteria and a significant number of patients did not attend the consultation due to deteriorating performance status. Earlier referral, and increased awareness may optimise genetic services referral for patients with PDAC.
