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- Title:
Risk of malignancy in resected pancreatic mucinous cystic neoplasms.
- Document type:
- Article; Proceedings Paper; Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't
- Author(s):
- Keane, M G; Shamali, A; Nilsson, L N; Antila, A; Millastre Bocos, J; Marijinissen Van Zanten, M; Verdejo Gil, C; Maisonneuve, P; Vaalavuo, Y; Hoskins, T; Robinson, S; Ceyhan, G O; Abu Hilal, M; Pereira, S P; Laukkarinen, J; del Chiaro, M
- Abstract:
- BACKGROUND: Pancreatic mucinous cystic neoplasms (MCNs) are rare mucin-producing cystic tumours defined by the presence of ovarian-type stroma. MCNs have a malignant potential and thus surgery is frequently performed. The aim of this cohort study was to define better the criteria for surgical resection in patients with MCN. METHODS: This multicentre retrospective study included all resected MCNs between 2003 and 2015 in participating centres. Lesions without ovarian-type stroma were excluded. Patient characteristics, preoperative findings, histopathology findings and follow-up data were recorded. RESULTS: The study included 211 patients; their median age was 53 (range 18-82) years, and 202 (95·7 per cent) were women. Median preoperative tumour size was 55 (range 12-230) mm. Thirty-four of the 211 (16·1 per cent) were malignant, and high-grade dysplasia (HGD) was found in a further 13 (6·2 per cent). One-third of MCNs in men were associated with invasive cancer, compared with 15·3 per cent in women. Five cases of malignant transformation occurred in MCNs smaller than 4 cm. All cases of malignancy or HGD were associated with symptoms or features of concern on preoperative cross-sectional imaging. In multivariable analysis, raised carbohydrate antigen 19-9 (odds ratio (OR) 10·54, 95 per cent c.i. 2·85 to 218·23; P < 0·001), tumour size (OR 4·23, 3·02 to 11·03; P = 0·001), mural nodules (OR 3·55, 1·31 to 20·55; P = 0·002) and weight loss (OR 3·40, 2·34 to 12·34; P = 0·034) were independent factors predictive of malignant transformation. CONCLUSIONS: Small indeterminate MCNs with no symptoms or features of concern may safely be observed as they have a low risk of malignant transformation.
- Journal title abbreviation:
- Br J Surg
- Year:
- 2018
- Journal volume:
- 105
- Journal issue:
- 4
- Pages contribution:
- 439-446
- Fulltext / DOI:
- doi:10.1002/bjs.10787
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/29488646
- Print-ISSN:
- 0007-1323
- TUM Institution:
- Chirurgische Klinik und Poliklinik
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