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Limited resection of pancreatic cancer in high-risk patients can result in a second primary
  1. T P Potjer1,
  2. D K Bartsch2,
  3. E P Slater2,
  4. E Matthäi2,
  5. B A Bonsing3,
  6. H F A Vasen4
  1. 1Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Marburg, Germany
  3. 3Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
  4. 4Department of Gastroenterology & Hepatology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr H F A Vasen, Department of Gastroenterology & Hepatology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands; hfavasen{at}stoet.nl

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Dear Editor,

We read with interest the paper by Canto and coworkers recently published in Gut that provided guidelines for the management of individuals with a high risk for pancreatic ductal adenocarcinoma (PDAC).1 Although indications for surgery are discussed, no recommendations are given regarding the extent of surgery, that is, partial pancreatectomy (PP) or total pancreatectomy (TP), in cases with a small screen-detected PDAC. This is an important issue because it seems very likely that a hereditary background increases the risk for a second primary cancer of the pancreas. Here, we describe two high-risk individuals who developed a second primary tumour after a PP of an early-stage cancer.

Patient 1 is a 62-year-old woman with the common Dutch ‘p16-Leiden’ founder mutation in the CDKN2A gene and a medical history of melanoma at age 56. This patient was enrolled …

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