1. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)
- Author
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Luca Frulloni, I Gomatos, O Messina, Raghubinder S. Gill, Paolo Giorgio Arcidiacono, Vinicius Jardim Campos, Myriam Delhaye, W J Lee, Roberto Girelli, J M Urman Fernandez, Isabella Frigerio, Massimiliano Bissolati, Wataru Kimura, M Concepcion-Martin, T Ikeura, Jong Ho Moon, J Y Jang, Alessandro Bersch Osvaldt, Darwin L. Conwell, Riccardo Manfredi, Claudio Bassi, Maria Rachele Angiolini, Bertrand Napoleon, M Del Chiaro, B Jais, Riccardo Casadei, L S Lee, Atif Zaheer, Woohyun Jung, Ralph H. Hruban, F Bolado, D Oh, Ralf Segersvärd, Martina Fontana, Laura Maggino, Eva C. Vaquero, B Sastre, M A Rios-Vives, S Y Song, Rupert W. Leong, Anna Caterina Milanetto, Stephen P. Pereira, Margaret G. Keane, Giuseppe Malleo, Kazuichi Okazaki, Anne Marie Lennon, D H Song, I Araujo Acuna, Robert A. Moran, G Aguero Garcete, Hua Wang, Philippe Lévy, Stefano Crippa, Kofi Oppong, Giovanni Marchegiani, Vinciane Rebours, Myung-Hwan Kim, K V Kopchak, Darren Pavey, Chang Moo Kang, Matthew T. Huggett, Roberto Salvia, Claudio Ricci, Giovanni Morana, B Bernier, Alessandro Zerbi, C. De Angelis, Christopher L. Wolfgang, C. Fernandez del Castillo, M Shinzeki, Cosimo Sperti, Alex Faccinetto, Gianpaolo Balzano, Ichiro Hirai, Mehdi Ouaissi, Massimo Falconi, Y Ha, M Spandre, K T Jang, William R. Brugge, John P. Neoptolemos, M C Petrone, H J Choi, Huapyong Kang, I Matsumoto, J Tang, S W Kim, L Pererva, Jais, B, Rebours, V, Malleo, G, Salvia, R, Fontana, M, Maggino, L, Bassi, C, Manfredi, R, Moran, R, Lennon, A M, Zaheer, A, Wolfgang, C, Hruban, R, Marchegiani, G, Fernández Del Castillo, C, Brugge, W, Ha, Y, Kim, M H, Oh, D, Hirai, I, Kimura, W, Jang, J Y, Kim, S W, Jung, W, Kang, H, Song, S Y, Kang, C M, Lee, W J, Crippa, S, Falconi, M, Gomatos, I, Neoptolemos, J, Milanetto, A C, Sperti, C, Ricci, C, Casadei, R, Bissolati, M, Balzano, G, Frigerio, I, Girelli, R, Delhaye, M, Bernier, B, Wang, H, Jang, K T, Song, D H, Huggett, M T, Oppong, K W, Pererva, L, Kopchak, K V, Del Chiaro, M, Segersvard, R, Lee, L S, Conwell, D, Osvaldt, A, Campos, V, Aguero Garcete, G, Napoleon, B, Matsumoto, I, Shinzeki, M, Bolado, F, Fernandez, J M Urman, Keane, M G, Pereira, S P, Acuna, I Araujo, Vaquero, E C, Angiolini, M R, Zerbi, A, Tang, J, Leong, R W, Faccinetto, A, Morana, G, Petrone, M C, Arcidiacono, P G, Moon, J H, Choi, H J, Gill, R S, Pavey, D, Ouaïssi, M, Sastre, B, Spandre, M, De Angelis, C G, Rios-Vives, M A, Concepcion-Martin, M, Ikeura, T, Okazaki, K, Frulloni, L, Messina, O, Lévy, P, Lennon, Am, Kim, Mh, Jang, Jy, Kim, Sw, Song, Sy, Kang, Cm, Lee, Wj, Milanetto, Ac, Jang, Kt, Song, Dh, Huggett, Mt, Oppong, Kw, Kopchak, Kv, Lee, L, Fernandez, Jm, Keane, Mg, Pereira, Sp, Acuna, Ia, Vaquero, Ec, Angiolini, Mr, Leong, Rw, Petrone, Mc, Arcidiacono, P. G., Moon, Jh, Choi, Hj, Gill, R, De Angelis, Cg, Rios-Vives, Ma, and Lévy, P.
- Subjects
Male ,Abdominal pain ,Internationality ,PANCREATIC SURGERY ,PANCREATIC TUMOURS ,Cystadenoma ,Gastroenterology ,0302 clinical medicine ,80 and over ,Medicine ,Societies, Medical ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,Aged, 80 and over ,Cystadenoma, Serous ,Middle Aged ,Europe ,Serous fluid ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,medicine.symptom ,hormones, hormone substitutes, and hormone antagonists ,Adult ,medicine.medical_specialty ,endocrine system ,Adolescent ,Pancreatic serous cystadenoma ,Malignancy ,Asymptomatic ,Aged ,Humans ,Retrospective Studies ,Young Adult ,Pancreatic Neoplasms ,03 medical and health sciences ,Internal medicine ,Medical ,business.industry ,Serous ,Retrospective cohort study ,medicine.disease ,Cystic Neoplasm ,Surgery ,stomatognathic diseases ,nervous system ,sense organs ,business ,Societies - Abstract
Objectives Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16–99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2–200)), 9% had resection beyond 1 year of follow-up (3 years (1–20), size at diagnosis: 25 mm (4–140)) and 39% had no surgery (3.6 years (1–23), 25.5 mm (1–200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN9s related mortality was 0.1% (n=1). Conclusions After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. Trial registration number IRB 00006477.
- Published
- 2016