Surveillance and Management for Serous Cystic Neoplasms of the Pancreas Based on Total Hazards-a Multi-center Retrospective Study from China

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2020 Feb 12

PMID 32042823

Citations 3

Authors

Wenchuan Wu

Ji Li

Ning Pu

Gang Li

Xin Wang

Gang Zhao

Lei Wang

Xiaodong Tian

Chunhui Yuan

Yi Miao

Kuirong Jiang

Jun Cao

Xiaowu Xu

Xueli Bai

Yongsheng Yang

Fubao Liu

Xuewei Bai

Rui Kong

Zheng Wang

Deliang Fu

Wenhui Lou

Affiliations

Soon will be listed here.

Abstract

Background: Serous cystic neoplasms (SCN) rarely have malignant potential, so accurate diagnosis of SCN is crucial for proper clinical management, especially to avoid unnecessary surgeries. However, the misdiagnosis of other pancreatic cystic neoplasm instead of SCN may highly increase the risk of malignancy in patients who receive no surgery.

Methods: Data from a total of 678 patients with pathologically confirmed to have SCN at sixteen institutions in China from January 1, 2006 to December 31, 2016 were retrieved to evaluate the malignancy risk of SCN.

Results: Among the 678 patients confirmed to have SCN with postoperative pathologic analysis, 649 patients (95.7%) had only one lesion and the average maximum diameter was 3.8±2.47 cm. Four patients were pathologically verified as having serous cystadenocarcinoma, so the SCN actual malignancy rate was 0.6%, while the mortality due to pancreatic surgery in these high-volume centers was nearly 0.2-2%. However, among the 99 SCN patients based on preoperative radiology, three were confirmed to have intraductal papillary mucinous neoplasms (IPMN), nine as mucinous cystic neoplasms (MCN), and four as solid pseudopapillary tumors (SPT) after postoperative pathological analysis. Thus, the total theoretical malignancy rate resulting from preoperative misdiagnosis was elevated to approximately 2.9%, higher than the risk of perioperative mortality.

Conclusions: When SCN can't be accurately distinguished from cystic tumors of pancreas, the malignant risk of cystic tumors may be higher than perioperative risk. However, if it can be diagnosed as SCN accurately, surgery can be avoided as well.

Citing Articles

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