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01-10-2007 | Original Article

Outcomes of Cystic Lesions in the Pancreas After Extended Follow-up

Authors: Sang Hyub Lee, Cheol Min Shin, Joo Kyung Park, Sang Myung Woo, Ji Won Yoo, Ji Kon Ryu, Yong Bum Yoon, Yong-Tae Kim

Published in: Digestive Diseases and Sciences | Issue 10/2007

Abstract

Incidental pancreatic cysts are frequently detected, but no appropriate management guidelines have been issued for their management because their natural history is relatively unknown. The aim of this study was to investigate their long-term clinical outcomes. Pancreatic cysts detected from 1998 to 2004 were retrospectively reviewed in patients followed up for more than 3 months. A total of 182 patients with incidental pancreatic cysts (initial mean size, 1.8±1.1 cm) underwent follow-up for an average of 35.4 months. An age≥60 years was found to be associated with an increase in cyst size, with an odds ratio of 2.56. Two malignant cysts were found among 20 patients who underwent surgical resection during follow-up. Old age was also associated with the presence of a premalignant or malignant cyst (P<0.01). Although the majority of incidental pancreatic cysts show an indolent behavior, long-term, regular follow-up studies should be considered for all pancreatic cysts, especially in the elderly.

Balcom IJ, Fernandez-Del Castillo C, Warshaw AL (2000) Cystic lesions in the pancreas: when to watch, when to resect. Curr Gastroenterol Rep 2:152–158CrossRef

Kiely JM, Nakeeb A, Komorowski RA, Wilson SD, Pitt HA (2003) Cystic pancreatic neoplasms: Enucleate or resect? J Gastrointest Surg 7:890–897PubMedCrossRef

Fernandez-del Castillo C, Targarona J, Thayer SP, Rattner DW, Brugge WR, Warshaw AL (2003) Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg 138:427–423, discussion 433–424PubMedCrossRef

Megibow AJ, Lombardo FP, Guarise A, Carbognin G, Scholes J, Rofsky NM, Macari M, Balthazar EJ, Procacci C (2001) Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging 26:640–647PubMedCrossRef

Horvath KD, Chabot JA (1999) An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg 178:269–274PubMedCrossRef

Gasslander T, Arnelo U, Albiin N, Permert J (2001) Cystic tumors of the pancreas. Dig Dis 19:57–62PubMedCrossRef

Meyer W, Kohler J, Gebhardt C (1999) Cystic neoplasms of the pancreas—cystadenomas and cystadenocarcinomas. Langenbecks Arch Surg 384:44–49PubMedCrossRef

Allen PJ, Jaques DP, D’Angelica M, Bowne WB, Conlon KC, Brennan MF (2003) Cystic lesions of the pancreas: selection criteria for operative and nonoperative management in 209 patients. J Gastrointest Surg 7:970–977PubMedCrossRef

Suzuki Y, Atomi Y, Sugiyama M, Isaji S, Inui K, Kimura W, Sunamura M, Furukawa T, Yanagisawa A, Ariyama J, Takada T, Watanabe H, Suda K (2004) Cystic neoplasm of the pancreas: a Japanese multiinstitutional study of intraductal papillary mucinous tumor and mucinous cystic tumor. Pancreas 28:241–246PubMedCrossRef

10.

Harper AE, Eckhauser FE, Mulholland MW (2002) Resectional therapy for cystic neoplasms of the pancreas. Am Surg 68:353–357, discussion 357–358PubMed

11.

Spinelli KS, Fromwiller TE, Daniel RA, Kiely JM, Nakeeb A, Komorowski RA, Wilson SD, Pitt HA (2004) Cystic pancreatic neoplasms: observe or operate. Ann Surg 239:651–657PubMedCrossRef

12.

Talamini MA, Pitt HA, Hruban RH, Boitnott JK, Coleman J, Cameron JL (1992) Spectrum of cystic tumors of the pancreas. Am J Surg 163:117–123, discussion 123–114PubMedCrossRef

13.

Talamini MA, Moesinger R, Yeo CJ, Poulose B, Hruban RH, Cameron JL, Pitt HA (1998) Cystadenomas of the pancreas: Is enucleation an adequate operation? Ann Surg 227:896–903PubMedCrossRef

14.

Moesinger RC, Talamini MA, Hruban RH, Cameron JL, Pitt HA (1999) Large cystic pancreatic neoplasms: pathology, resectability, and outcome. Ann Surg Oncol 6:682–690PubMedCrossRef

15.

Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR (1990) Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg 212:432–443, discussion 444–435PubMedCrossRef

16.

Ikeda M, Sato T, Ochiai M, Morozumi A, Ainota T, Fujino MA (1993) Ultrasonographic follow-up study of small pancreatic cysts of unknown etiology. Bildgebung 60:209–214PubMed

17.

Sahani DV, Saokar A, Hahn PF, Brugge WR, Fernandez-Del Castillo C (2006) Pancreatic cysts 3 cm or smaller: how aggressive should treatment be? Radiology 238:912–919PubMedCrossRef

18.

Walsh RM, Vogt DP, Henderson JM, Zuccaro G, Vargo J, Dumot J, Herts B, Biscotti CV, Brown N (2005) Natural history of indeterminate pancreatic cysts. Surgery 138:665–670, discussion 670–671PubMedCrossRef

19.

Handrich SJ, Hough DM, Fletcher JG, Sarr MG (2005) The natural history of the incidentally discovered small simple pancreatic cyst: long-term follow-up and clinical implications. AJR Am J Roentgenol 184:20–23PubMed

20.

Le Borgne J, de Calan L, Partensky C (1999) Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association. Ann Surg 230:152–161PubMedCrossRef

21.

Sarr MG, Kendrick ML, Nagorney DM, Thompson GB, Farley DR, Farnell MB (2001) Cystic neoplasms of the pancreas: ben ign to malignant epithelial neoplasms. Surg Clin North Am 81:497–509PubMedCrossRef

22.

Jang JY, Kim SW, Ahn YJ, Yoon YS, Choi MG, Lee KU, Han JK, Kim WH, Lee YJ, Kim SC, Han DJ, Kim YI, Choi SH, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee KB, Kim YC, Lee KS, Kim MW, Kim HJ, Kim HJ, Park YH (2005) Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: Is it possible to predict the malignancy before surgery? Ann Surg Oncol 12:124–132PubMedCrossRef

23.

Sohn TA, Yeo CJ, Cameron JL, Iacobuzio-Donahue CA, Hruban RH, Lillemoe KD (2001) Intraductal papillary mucinous neoplasms of the pancreas: an increasingly recognized clinicopathologic entity. Ann Surg 234:313–321, discussion 321–312PubMedCrossRef

24.

Chari ST, Yadav D, Smyrk TC, DiMagno EP, Miller LJ, Raimondo M, Clain JE, Norton IA, Pearson RK, Petersen BT, Wiersema MJ, Farnell MB, Sarr MG (2002) Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. Gastroenterology 123:1500–1507PubMedCrossRef

25.

Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L (2002) Pancreatic cysts: depiction on single-shot fast spin-echo MR images. Radiology 223:547–553PubMedCrossRef

26.

Curry CA, Eng J, Horton KM, Urban B, Siegelman S, Kuszyk BS, Fishman EK (2000) CT of primary cystic pancreatic neoplasms: Can CT be used for patient triage and treatment? AJR Am J Roentgenol 175:99–103PubMed

27.

Centeno BA (2002) Role of cytology in the diagnosis of cystic and intraductal papillary mucinous neoplasms. Gastrointest Endosc Clin N Am 12:697–708PubMedCrossRef

28.

Recine M, Kaw M, Evans DB, Krishnamurthy S (2004) Fine-needle aspiration cytology of mucinous tumors of the pancreas. Cancer 102:92–99PubMedCrossRef

29.

Sarr MG, Murr M, Smyrk TC, Yeo CJ, Fernandez-del-Castillo C, Hawes RH, Freeny PC (2003) Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions. J Gastrointest Surg 7:417–428PubMedCrossRef

Title: Outcomes of Cystic Lesions in the Pancreas After Extended Follow-up
Authors: Sang Hyub Lee
Cheol Min Shin
Joo Kyung Park
Sang Myung Woo
Ji Won Yoo
Ji Kon Ryu
Yong Bum Yoon
Yong-Tae Kim
Publication date: 01-10-2007
Publisher: Springer US
Published in: Digestive Diseases and Sciences / Issue 10/2007
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-006-9634-y

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