Evidence map›Paper›PMID 41514529›Full record

ReviewCancers2025

Depression as a Prodromal Symptom of Pancreatic Cancer: A Narrative Review.

Chiara Deori, Federica Andreis, Valentina Giubileo, Silvia Noventa, Ester Oneda, Fausto Meriggi, Alberto Zaniboni

Abstract readReview
In one paragraph

Review in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chiara DeoriOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.ORCID 0009-0001-5881-1215
Federica AndreisOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.
Valentina GiubileoOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.ORCID 0009-0003-0000-1484
Silvia NoventaOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.ORCID 0000-0001-7423-6065
Ester OnedaOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.ORCID 0000-0002-7861-7882
Fausto MeriggiOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.
Alberto ZaniboniOncology Department, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies, typically diagnosed at an advanced stage. The identification of prodromal symptoms could support earlier detection. Among these, depression is frequently reported, raising the question of whether it may represent not only a reactive response but also a paraneoplastic manifestation.

methodsWe conducted a narrative review of clinical, epidemiological and biological literature published between 1988 and 2025. Searches were performed in PubMed/MEDLINE, Scopus, and Web of Science using predefined keywords related to pancreatic cancer, depression, prodromal symptoms, cytokines, and the kynurenine pathway. Eligible studies included clinical cohorts, population-based analyses, biological investigations, and case reports exploring the temporal or mechanistic link between depression and PDAC.

resultsA substantial proportion of patients (10-20%) exhibit depressive symptoms in the months preceding the clinical diagnosis of pancreatic cancer. In several cases, depression occurs independent of weight loss and new-onset diabetes. Biological evidence highlights the involvement of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), NF-κB signaling, and activation of the tryptophan-kynurenine pathway (IDO), suggesting a link between tumor-related processes and mood alterations. These mechanistic findings are actually hypothesis-generating, deriving mainly from small clinical cohorts and preclinical models. Clinically, depression is associated with reduced adherence to treatment, poorer quality of life, and shorter survival. However, no specific depressive phenotype has been identified.

conclusionsDepression may represent a potential prodromal symptom of pancreatic cancer, reflecting systemic biological processes as well as psychological reactions. Its utility as a standalone marker remains limited; future studies should integrate psychiatric, clinical and biological biomarker assessments to enhance early clinical diagnosis.

Indexed as

cytokinesdepressionkynurenine pathwaypancreatic cancerprodromal symptoms

Identifiers

PMID41514529
PMCPMC12785060

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.