Outcomes in patients with pancreatic cancer as a secondary malignancy: a retrospective single-institution study

  • Sojun HoshimotoEmail author
  • Shoichi Hishinuma
  • Hirofumi Shirakawa
  • Moriaki Tomikawa
  • Iwao Ozawa
  • Yoshiro Ogata
Original Article



This study aimed to evaluate the clinicopathological features and oncological outcomes of pancreatic cancer (PC) patients with prior malignancies (2nd primary PC) compared with those of patients without any prior malignancies in their history (1st primary PC).


We retrospectively reviewed clinical data from 185 PC patients undergoing surgical resection. Patients were divided into the 1st and 2nd primary PC groups.


Forty-three patients (23.2%) had a history of prior malignancy. The 2nd primary PC group was significantly older than the 1st primary PC group (mean, 72.1 vs. 65.9 years, respectively, P < 0.001) and was more frequently asymptomatic compared to the 1st primary PC group (67.4 vs. 31.0%, respectively, P < 0.001). The tumor size was larger, and extrapancreatic nerve plexus invasion, venous invasion, and lymph node metastasis were more frequently observed in the 1st primary PC group. The rate of adjuvant therapy administration was lower in 2nd primary PC patients (72.5 vs. 51.2%, P = 0.009). In the survival analysis, no significant difference in overall or disease-free survival was found between the two groups (16.8 vs. 16.4 months, P = 0.725, and 8.7 vs. 9.3 months, P = 0.284, respectively).


Despite significant surveillance bias, such as earlier detection in 2nd primary PC, the outcomes of patients with 2nd primary PC were comparable to those of patients with 1st primary PC. Further investigation with a larger sample size and matching for patient age and tumor stage in both groups is needed to elucidate the biological features of 2nd primary PC.


Multiple primary malignancy Pancreatic cancer Second primary cancer Systemic inflammatory response 


Authors’ contributions

Hoshimoto S designed the report; Hishinuma S, Shirakawa H, Tomikawa M, Ozawa I, and Ogata Y were in charge of patient treatment and data acquisition; Hoshimoto S analyzed the data and drafted the manuscript; Hishinuma S and Ogata Y critically revised the manuscript. All authors approved the final version of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures involving human participants were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

423_2019_1841_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 19 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sojun Hoshimoto
    • 1
    Email author
  • Shoichi Hishinuma
    • 1
  • Hirofumi Shirakawa
    • 1
  • Moriaki Tomikawa
    • 1
  • Iwao Ozawa
    • 1
  • Yoshiro Ogata
    • 1
  1. 1.Department of Digestive SurgeryTochigi Cancer CenterUtsunomiyaJapan

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