The faith of non-surveilled pancreatic cysts: a bicentric retrospective study.

Published on Jun 8, 2021in Ejso3.959
· DOI :10.1016/J.EJSO.2021.06.007
N. Surci (Medical University of Vienna), Giovanni Marchegiani29
Estimated H-index: 29
+ 9 AuthorsClaudio Bassi110
Estimated H-index: 110
Abstract null null Background null Incidental 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. null null null Materials and methods null A 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. null null null Results null Overall, 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). null null null Conclusion null The “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.
#2Andrea CaravatiH-Index: 3
Last. Roberto SalviaH-Index: 52
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OBJECTIVE Our aim is to provide a real-life picture of serous cystic neoplasms (SCNs) management once a presumptive diagnosis is made. SUMMARY BACKGROUND DATA SCNs of the pancreas are invariably benign entities. While consensus about their management is lacking, surgical resection still plays a role. METHODS Presumed SCNs evaluated from 1990 to 2018 were included. Indications for surgery, predictors of resection, rate and predictors of misdiagnosis in the surgical cohort and time trends of manag...
1 CitationsSource
#1Roberto Salvia (University of Verona)H-Index: 52
#2Giovanni Marchegiani (University of Verona)H-Index: 29
1 CitationsSource
#1Debora Ciprani (Harvard University)H-Index: 4
#2Maximilian Weniger (Harvard University)H-Index: 11
Last. C. Fernandez-del Castillo (Harvard University)H-Index: 17
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Abstract Background Pancreatic cysts Methods Bi-centric study utilizing prospectively collected databases of patients with pancreatic cysts measuring Results 806 patients were identified. Median follow-up was 58 months (6–347). Over time, 58 (7.2%) cysts were resected and of those, 11 had high grade dysplasia (HGD) or invasive cancer. Three additional patients had unresectable cancer for a total rate of malignancy of 1.7%. Predictors of development of malignancy included an increase in size ≥2.5...
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#1Veronica Marinelli (University of Verona)H-Index: 9
#2Erica Secchettin (University of Verona)H-Index: 13
Last. Roberto Salvia (University of Verona)H-Index: 52
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Abstract Introduction Most intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can be safely surveilled. Their psychological impact is not known. The aim of this study is to obtain a psychological profile of patients under surveillance and compare the results to patients undergoing surgery. Methods Patients under surveillance for IPMNs evaluated between 2017 and 2019 at the pancreatic cysts clinic of The Pancreas Institute of Verona were compared to patients undergoing surgery for t...
6 CitationsSource
#1Giampaolo PerriH-Index: 9
Last. Roberto SalviaH-Index: 52
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Background: The prevalence of undefined pancreatic cystic neoplasms (PCNs) is high in the general population, increasing with patient age. PCNs account for different biological entities with different potential for malignant transformation. The clinician must balance his or her practice between the risk of surgical overtreatment and the error of keeping a malignant lesion under surveillance. Methods: We review and discuss the clinical management of PCNs. Specifically, we analyze the main feature...
8 CitationsSource
#1Giovanni Marchegiani (University of Verona)H-Index: 29
#2Stefano Andrianello (University of Verona)H-Index: 16
Last. Roberto Salvia (University of Verona)H-Index: 52
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OBJECTIVES:The management of small and incidental branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) still is of concern. The aim is assessing the safety of a surveillance protocol through the evaluation of their progression to malignancy.METHODS:All presumed BD-IPMNs observed from 2000
20 CitationsSource
#1Luca Morelli (UniPi: University of Pisa)H-Index: 21
#2Simone Guadagni (UniPi: University of Pisa)H-Index: 13
Last. Giulio Di CandioH-Index: 15
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#1Sarah B. Bateni (UC Davis: University of California, Davis)H-Index: 7
#2Jennifer L Olson (UC Davis: University of California, Davis)H-Index: 2
Last. Richard J. Bold (UC Davis: University of California, Davis)H-Index: 46
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© 2018, Society of Surgical Oncology. Background: Outcomes for pancreatic resection have been studied extensively due to the high morbidity and mortality rates, with high-volume centers achieving superior outcomes. Ongoing investigations include healthcare costs, given the national focus on reducing expenditures. Therefore, we sought to evaluate the relationships between pancreatic surgery costs with perioperative outcomes and volume status. Methods: We performed a retrospective analysis of 27,6...
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#1Giulia MaggiH-Index: 4
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Pancreatic cystic neoplasms are one of the most frequent incidental findings in the field of pancreatic diseases, estimated to be present in up to 45% of the general population. They represent an heterogeneous group of tumors with different biological behavior and variable risk of progression to malignancy. While serous cystadenomas (SCAs) have no risk of malignant progression, mucinous cyst adenoma are malignant in 20% of cases and this risk is higher in intraductal papillary mucinous neoplasms...
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#1Stefano AndrianelloH-Index: 16
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: The sudden prevalence increase of pancreatic cystic neoplasms (PCN) related to the use of cross-sectional imaging has raised several concerns. Even if there is a tangible risk of progression towards pancreatic cancer (PC), surgical resection cannot be offered to all patients due to the high risk of morbidity and mortality. Available guidelines are useful tools to identify patients at higher risk for harboring cancer thanks to their sensitivity. Because of their low specificity, however, such a...
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