Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2021; 27(27): 4371-4382
Published online Jul 21, 2021. doi: 10.3748/wjg.v27.i27.4371
Impact of surgery for chronic pancreatitis on the risk of pancreatic cancer: Untying the Gordian knot
Raja Kalayarasan, Sankar Narayanan, Jayaprakash Sahoo, Pazhanivel Mohan
Raja Kalayarasan, Sankar Narayanan, Department of Surgical Gastroenterology, JIPMER, Puducherry 605006, India
Jayaprakash Sahoo, Department of Endocrinology, JIPMER, Puducherry 605006, India
Pazhanivel Mohan, Department of Medical Gastroenterology, JIPMER, Puducherry 605006, India
Author contributions: Kalayarasan R, Narayanan S, Sahoo J and Mohan P did the literature search; Kalayarasan R wrote the first draft of the review; Narayanan S, Sahoo J and Mohan P conceptualized the work, supervised the writing, gave intellectual input, and critically revised the manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Raja Kalayarasan, MBBS, MCh, MS, Associate Professor, Department of Surgical Gastroenterology, JIPMER, Dhanvnatri nagar, Gorimedu, Puducherry 605006, India.
Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: May 2, 2021
Revised: May 10, 2021
Accepted: June 22, 2021
Article in press: June 22, 2021
Published online: July 21, 2021
Core Tip

Core Tip: Chronic pancreatitis (CP) is a significant risk factor for pancreatic cancer (PC). However, the relative risk is not as high as previously reported. Persistent pancreatic inflammation plays an important role in pancreatic carcinogenesis, and genetic mutations implicated in the pathogenesis of CP are not directly involved in the development of PC. Although surgery for CP reduces the risk of PC, the evidence is not strong enough to recommend routine prophylactic surgery in CP patients. The risk stratification proposed in this review considers the genetic and environmental factors that could guide future prospective studies and select patients for prophylactic surgery.