The faith of non-surveilled pancreatic cysts: a bicentric retrospective study |
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| Affiliation: | 1. Department of Surgery, Medical University of Vienna, General Hospital, Vienna, Austria;2. Department of General and Pancreatic Surgery, Pancreas Institute, University and Hospital Trust of Verona, “GB Rossi” Hospital, Verona, Italy;3. Department of Radiology, Medical University of Vienna, General Hospital, Vienna, Austria;1. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China;2. Faculty of Hepato-Biliary-Pancreatic Surgery, The First Medical Center of Chinese People''s Liberation Army (PLA) General Hospital, Beijing, China;3. College of Basic Medical Sciences, Second Military Medical University, Shanghai, China;4. Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical College, Shandong, China;5. Department of General Surgery, Wenzhou People''s Hospital, Zhejiang, China;6. Department of Hepatobiliary Surgery, Longyan First Hospital, Affiliated to Fujian Medical University, Fujian, China;7. Department of General Surgery, Zhejiang Provincial Armed Police Corps Hospital, Zhejiang, China;8. PLA 92493 Army Hospital, Liaoning, China;9. Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China;1. Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA;2. Yale Cancer Center, New Haven, CT, USA;1. Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China;2. Department of Colorectal Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, 110042, China;3. Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China;4. Department of Liver Surgery and Liver Transplantation Center, State Key Laboratory of Biotherapy and Cancer Center, Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China;5. Department of Abdominal Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China;6. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan |
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| Abstract: | BackgroundIncidental discovery of pancreatic cystic neoplasms (PCLs) is a common and steadily increasing occurrence. The aim of this study was to investigate a cohort of patients presenting with incidentally detected PCLs which were not included in a surveillance protocol, and to compare their risk of malignant evolution with that of systematically surveilled lesions.Materials and methodsA population of PCLs which did not receive surveillance over a period >10 years (population A) was selected at the Medical University of Vienna. A group of “low risk” branch duct intraductal papillary mucinous neoplasm ≤15 mm in size upon diagnosis undergoing a regular follow-up of at least 5 years at the University of Verona was selected as control (population B). The incidence of pancreatic cancer (PC), cumulative risk of PC and disease-specific survival were compared.ResultsOverall, 376 patients with non-surveilled PCLs were included in study group A and compared to 299 patients in group B. This comparison resulted in similar incidence rates of PC (1.6% vs 1.7%, p = 0.938), a strong similarity in terms of disease-specific mortality rates (1.3% vs 0.3%, p = 0.171) and the 5- and 10-year cumulative risk of PC (? 1% and 2%, p = 0.589) and DSS (? 100% and 98%, p = 0.050).ConclusionThe “price to pay” for a negligence-based policy in the population of non-surveilled PCLs was reasonable, and the incidence of PC was comparable to that reported for a population of low-risk cysts enrolled to a standardized surveillance protocol. |
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| Keywords: | Pancreas Pancreatic cysts IPMN Surveillance Surgery Pancreatic cancer |
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