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01-10-2017 | SSAT Quick Shot Presentation

Natural History of Patients Followed Radiographically with Mucinous Cysts of the Pancreas

Authors: Linda M. Pak, Michael I. D’Angelica, Ronald P. DeMatteo, T. Peter Kingham, Vinod P. Balachandran, William R. Jarnagin, Peter J. Allen

Published in: Journal of Gastrointestinal Surgery | Issue 10/2017

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.

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Title: Natural History of Patients Followed Radiographically with Mucinous Cysts of the Pancreas
Authors: Linda M. Pak
Michael I. D’Angelica
Ronald P. DeMatteo
T. Peter Kingham
Vinod P. Balachandran
William R. Jarnagin
Peter J. Allen
Publication date: 01-10-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 10/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-016-3338-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Natural History of Patients Followed Radiographically with Mucinous Cysts of the Pancreas

Abstract

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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