Natural history of patients followed radiographically with mucinous cysts of the pancreas Journal Article
| Authors: | Pak, L. M.; D’Angelica, M. I.; DeMatteo, R. P.; Kingham, T. P.; Balachandran, V. P.; Jarnagin, W. R.; Allen, P. J. |
| Article Title: | Natural history of patients followed radiographically with mucinous cysts of the pancreas |
| Abstract: | Objective: The aim of this study was to evaluate the outcome of patients presumed to have mucinous cysts of the pancreas who were initially selected for radiographic surveillance. Methods: Patients with a pancreatic cyst and a measured cyst fluid carcinoembryonic antigen (CEA) ≥192 ng/mL were included. Patients were stratified by those who underwent initial resection and those who were recommended for radiographic surveillance. The natural history of these two groups was examined. Results: From 1999 to 2014, 227 patients were identified who had a cyst fluid CEA ≥192 ng/mL (median 961, range 192–300,000 ng/mL). Immediate resection was performed on 63 patients (28%). Initial radiographic surveillance was recommended for 164 patients; 87% did not have main pancreatic duct dilation, and 87% met consensus criteria for radiographic surveillance. After a median follow-up of 56 months, 48 of the 164 patients (29%) had undergone resection. Ultimately, there were three cases (2%) of high-grade dysplasia and two cases of invasive carcinoma (1%) within these 164 patients selected for observation. Three of the five cases of either high-grade dysplasia or invasive carcinoma were among the 22 patients followed outside of consensus guidelines. Conclusions: Appropriately selected patients with mucinous pancreatic cysts can be safely followed with serial surveillance with a low risk of malignant progression. © 2017, The Society for Surgery of the Alimentary Tract. |
| Keywords: | intraductal papillary mucinous neoplasm; pancreatic cyst; mucinous cyst; pancreatic cystic neoplasm |
| Journal Title: | Journal of Gastrointestinal Surgery |
| Volume: | 21 |
| Issue: | 10 |
| ISSN: | 1091-255X |
| Publisher: | Springer |
| Date Published: | 2017-10-01 |
| Start Page: | 1599 |
| End Page: | 1605 |
| Language: | English |
| DOI: | 10.1007/s11605-016-3338-1 |
| PROVIDER: | scopus |
| PUBMED: | 28516310 |
| PMCID: | PMC5693653 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 October 2017 -- Source: Scopus |
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637DeMatteo -
501Allen -
905Jarnagin -
779D'Angelica -
612Kingham -
253Balachandran -
30Pak
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