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

BACKGROUND/AIMS: 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. RESULTS: 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. CONCLUSIONS: 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.

[Two cases of recurrent hydropneumothorax caused by malignant pleural mesothelioma].

We reported and reviewed 8 cases including two authors' cases in the Japanese literature, the incidence of pneumothorax associated with primary pulmonary neoplasms was less than 0.05%, however, in the case of malignant pleural mesothelioma, was as high as 10.36%. Mean age of patients was 67 year-old and recurrent hydropneumothorax was characterized in the clinical course. For the elderly with hydropneumothorax, it was necessary to rule out the malignant mesothelioma based on the past history of asbestos exposure, analysis of value of hyaluronic acid in the pleural effusion and the CT scan findings revealing pleural thickening, plaques and nodules. Only two out of 8 cases, were possible to undergo curative resection. Two authors' cases had undergone pleura resection and pathological findings indicated epithelial type of malignant mesothelioma. One died in 3 years and the other has been alive for one and half year since the operation.