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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Pak, LM; D'Angelica, MI; DeMatteo, RP; Kingham, TP; Balachandran, VP; Jarnagin, WR; Allen, PJ

Published Date

  • October 2017

Published In

Volume / Issue

  • 21 / 10

Start / End Page

  • 1599 - 1605

PubMed ID

  • 28516310

Pubmed Central ID

  • 28516310

Electronic International Standard Serial Number (EISSN)

  • 1873-4626

Digital Object Identifier (DOI)

  • 10.1007/s11605-016-3338-1

Language

  • eng

Conference Location

  • United States