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)
Por:
Jais, B, Rebours, V, Malleo, G, Salvia, R, Fontana, M, Maggino, L, Bassi, C, Manfredi, R, Moran, R, Lennon, AM, Zaheer, A, Wolfgang, C, Hruban, R, Marchegiani, G, Del Castillo, CF, Brugge, W, Ha, Y, Kim, MH, Oh, D, Hirai, I, Kimura, W, Jang, JY, Kim, SW, Jung, W, Kang, H, Song, SY, Kang, CM, Lee, WJ, Crippa, S, Falconi, M, Gomatos, I, Neoptolemos, J, Milanetto, AC, Sperti, C, Ricci, C, Casadei, R, Bissolati, M, Balzano, G, Frigerio, I, Girelli, R, Delhaye, M, Bernier, B, Wang, H, Jang, KT, Song, DH, Huggett, MT, Oppong, KW, Pererva, L, Kopchak, KV, Del Chiaro, M, Segersvard, R, Lee, LS, Conwell, D, Osvaldt, A, Campos, V, Garcete, GA, Napoleon, B, Matsumoto, I, Shinzeki, M, Bolado, F, Fernandez, JMU, Keane, MG, Pereira, SP, Acuna, IA, Vaquero, EC, Angiolini, MR, Zerbi, A, Tang, J, Leong, RW, Faccinetto, A, Morana, G, Petrone, MC, Arcidiacono, PG, Moon, JH, Choi, HJ, Gill, RS, Pavey, D, Ouaissi, M, Sastre, B, Spandre, M, De Angelis, CG, Rios-Vives, MA, Concepcion-Martin, M, Ikeura, T, Okazaki, K, Frulloni, L, Messina, O, Levy, P
Publicada:
1 feb 2016
Resumen:
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 (4140)) 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 SCN's 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.
Filiaciones:
Jais, B:
Beaujon Hosp, AP HP, Dept Gastroenterol & Pancreatol, 100 Blvd Gen Leclerc, F-92118 Clichy, France
Rebours, V:
Beaujon Hosp, AP HP, Dept Gastroenterol & Pancreatol, 100 Blvd Gen Leclerc, F-92118 Clichy, France
Malleo, G:
Univ Verona Hosp Trust, GB Rossi Hosp, Pancreas Inst, Verona, Italy
Salvia, R:
Univ Verona Hosp Trust, GB Rossi Hosp, Pancreas Inst, Verona, Italy
Fontana, M:
Univ Verona Hosp Trust, GB Rossi Hosp, Pancreas Inst, Verona, Italy
Maggino, L:
Univ Verona Hosp Trust, GB Rossi Hosp, Pancreas Inst, Verona, Italy
Bassi, C:
Univ Verona Hosp Trust, GB Rossi Hosp, Pancreas Inst, Verona, Italy
Manfredi, R:
Univ Verona Hosp Trust, GB Rossi Hosp, Pancreas Inst, Verona, Italy
Moran, R:
Johns Hopkins Univ, Sch Med, Div Gastroenterol & Hepatol, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Div Surg, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Dept Pathol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD USA
Lennon, AM:
Johns Hopkins Univ, Sch Med, Div Gastroenterol & Hepatol, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Div Surg, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Dept Pathol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD USA
Zaheer, A:
Johns Hopkins Univ, Sch Med, Div Gastroenterol & Hepatol, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Div Surg, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Dept Pathol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD USA
Wolfgang, C:
Johns Hopkins Univ, Sch Med, Div Gastroenterol & Hepatol, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Div Surg, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Dept Pathol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD USA
Hruban, R:
Johns Hopkins Univ, Sch Med, Div Gastroenterol & Hepatol, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Div Surg, Baltimore, MD USA
Johns Hopkins Univ, Sch Med, Dept Pathol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD USA
Marchegiani, G:
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Surg, Boston, MA 02115 USA
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02115 USA
Del Castillo, CF:
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Surg, Boston, MA 02115 USA
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02115 USA
Brugge, W:
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Surg, Boston, MA 02115 USA
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02115 USA
Ha, Y:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Gastroenterol, Seoul, South Korea
Kim, MH:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Gastroenterol, Seoul, South Korea
Oh, D:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Gastroenterol, Seoul, South Korea
Hirai, I:
Yamagata Univ, Fac Med, Dept Surg 1, Yamagata 990, Japan
Kimura, W:
Yamagata Univ, Fac Med, Dept Surg 1, Yamagata 990, Japan
Jang, JY:
Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea
Kim, SW:
Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea
Jung, W:
Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea
Kang, H:
Yonsei Univ, Coll Med, Dept Internal Med, Div Gastroenterol, Seoul 120749, South Korea
Song, SY:
Yonsei Univ, Coll Med, Dept Internal Med, Div Gastroenterol, Seoul 120749, South Korea
Kang, CM:
Yonsei Univ, Coll Med, Dept Surg,Severance Hosp, Pancreaticobiliary Canc Clin,Yonsei Canc Ctr, Seoul 120749, South Korea
Lee, WJ:
Yonsei Univ, Coll Med, Dept Surg,Severance Hosp, Pancreaticobiliary Canc Clin,Yonsei Canc Ctr, Seoul 120749, South Korea
Crippa, S:
Polytech Univ Marche Reg, Dept Surg, Pancreat Surg Unit, Ancona, Italy
Falconi, M:
Polytech Univ Marche Reg, Dept Surg, Pancreat Surg Unit, Ancona, Italy
Gomatos, I:
Univ Liverpool, NIHR Pancreas Biomed Res Unit, Dept Mol & Clin Canc Med, Royal Liverpool Univ Hosp,Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Neoptolemos, J:
Univ Liverpool, NIHR Pancreas Biomed Res Unit, Dept Mol & Clin Canc Med, Royal Liverpool Univ Hosp,Inst Translat Med, Liverpool L69 3BX, Merseyside, England
Milanetto, AC:
Univ Padua, Dept Surg Oncol & Gastroenterol, Surg Clin 3, Padua, Italy
Sperti, C:
Univ Padua, Dept Surg Oncol & Gastroenterol, Surg Clin 3, Padua, Italy
Ricci, C:
Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci DIMEC, S Orsola Malpighi Hosp, Bologna, Italy
Casadei, R:
Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci DIMEC, S Orsola Malpighi Hosp, Bologna, Italy
Bissolati, M:
IRCCS San Raffaele Sci Inst, Pancreat Surg Unit, Milan, Italy
Balzano, G:
IRCCS San Raffaele Sci Inst, Pancreat Surg Unit, Milan, Italy
Frigerio, I:
Pederzoli Hosp, Hepatopancreatobiliary Unit, Peschiera Del Garda, Italy
Girelli, R:
Pederzoli Hosp, Hepatopancreatobiliary Unit, Peschiera Del Garda, Italy
Delhaye, M:
Univ Libre Bruxelles, Erasme Univ Hosp, Dept Gastroenterol Hepatopancreatol & GI Oncol, Brussels, Belgium
Bernier, B:
Univ Libre Bruxelles, Erasme Univ Hosp, Dept Gastroenterol Hepatopancreatol & GI Oncol, Brussels, Belgium
Wang, H:
Third Mil Med Univ, Southwest Hosp, Inst Hepatopancreatobiliary Surg, Chongqing, Peoples R China
Jang, KT:
Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Pathol, Seoul, South Korea
Song, DH:
Gyeongsang Natl Univ, Sch Med, Dept Pathol, Jinju, South Korea
Huggett, MT:
Freeman Rd Hosp, Hepatopancreatobiliary Unit, Newcastle Upon Tyne, Tyne & Wear, England
Oppong, KW:
Freeman Rd Hosp, Hepatopancreatobiliary Unit, Newcastle Upon Tyne, Tyne & Wear, England
Pererva, L:
Nat Inst Surg & Transplantol, Kiev, Ukraine
Kopchak, KV:
Nat Inst Surg & Transplantol, Kiev, Ukraine
Del Chiaro, M:
Karolinska Univ Hosp, Karolinska Inst, Div Surg,Ctr Digest Dis, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden
Segersvard, R:
Karolinska Univ Hosp, Karolinska Inst, Div Surg,Ctr Digest Dis, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden
Lee, LS:
Brigham & Womens Hosp, Div Gastroenterol, 75 Francis St, Boston, MA 02115 USA
Conwell, D:
Brigham & Womens Hosp, Div Gastroenterol, 75 Francis St, Boston, MA 02115 USA
Osvaldt, A:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
Campos, V:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
Garcete, GA:
Hop Prive Mermoz, Gastroenterol, Lyon, France
Napoleon, B:
Hop Prive Mermoz, Gastroenterol, Lyon, France
Matsumoto, I:
Kobe Univ, Grad Sch Med, Dept Surg, Div Hepatobiliary Pancreat Surg, Kobe, Hyogo 657, Japan
Shinzeki, M:
Kobe Univ, Grad Sch Med, Dept Surg, Div Hepatobiliary Pancreat Surg, Kobe, Hyogo 657, Japan
Bolado, F:
Hosp Navarra, Dept Gastroenterol, Pamplona, Spain
Fernandez, JMU:
Hosp Navarra, Dept Gastroenterol, Pamplona, Spain
Keane, MG:
Univ Coll London Hosp, Dept Gastroenterol & Hepatol, London, England
Pereira, SP:
Univ Coll London Hosp, Dept Gastroenterol & Hepatol, London, England
Acuna, IA:
Univ Barcelona, Dept Gastroenterol, Hosp Clin, CIBEREHD,IDIBAPS, Barcelona, Spain
Vaquero, EC:
Univ Barcelona, Dept Gastroenterol, Hosp Clin, CIBEREHD,IDIBAPS, Barcelona, Spain
Angiolini, MR:
Humanitas Res Hosp, Dept Pancreat Surg, Milan, Italy
Zerbi, A:
Humanitas Res Hosp, Dept Pancreat Surg, Milan, Italy
Tang, J:
Concord Hosp, Gastroenterol & Liver Serv, Sydney, NSW, Australia
Leong, RW:
Concord Hosp, Gastroenterol & Liver Serv, Sydney, NSW, Australia
Faccinetto, A:
Gen Hosp Ca Foncello, Dept Radiol, Treviso, Italy
Morana, G:
Gen Hosp Ca Foncello, Dept Radiol, Treviso, Italy
Petrone, MC:
Ist Sci San Raffaele, Div Gastroenterol & Gastrointestinal Endoscopy, I-20132 Milan, Italy
Arcidiacono, PG:
Ist Sci San Raffaele, Div Gastroenterol & Gastrointestinal Endoscopy, I-20132 Milan, Italy
Moon, JH:
Soonchunhyang Univ, Sch Med, Digest Dis Ctr, Dept Internal Med, Bucheon, South Korea
Soonchunhyang Univ, Sch Med, Res Inst, Bucheon, South Korea
Choi, HJ:
Soonchunhyang Univ, Sch Med, Digest Dis Ctr, Dept Internal Med, Bucheon, South Korea
Soonchunhyang Univ, Sch Med, Res Inst, Bucheon, South Korea
Gill, RS:
Bankstown Lidcombe Hosp, Dept Gastroenterol, Bankstown, NSW, Australia
Pavey, D:
Bankstown Lidcombe Hosp, Dept Gastroenterol, Bankstown, NSW, Australia
Ouaissi, M:
Timone Hosp, Dept Digest Surg, Marseille, France
Sastre, B:
Timone Hosp, Dept Digest Surg, Marseille, France
Spandre, M:
Univ Turin, San Giovanni Battista Molinette Hosp, Dept Gastroenterol, Turin, Italy
De Angelis, CG:
Univ Turin, San Giovanni Battista Molinette Hosp, Dept Gastroenterol, Turin, Italy
Rios-Vives, MA:
Univ Autonoma Barcelona, Inst Recerca IIB St Pau, Hosp Santa Creu & St Pau, Dept Gastroenterol, E-08193 Barcelona, Spain
Concepcion-Martin, M:
Univ Autonoma Barcelona, Inst Recerca IIB St Pau, Hosp Santa Creu & St Pau, Dept Gastroenterol, E-08193 Barcelona, Spain
Ikeura, T:
Kansai Med Univ, Div Gastroenterol & Hepatol, Dept Internal Med 3, Osaka, Japan
Okazaki, K:
Kansai Med Univ, Div Gastroenterol & Hepatol, Dept Internal Med 3, Osaka, Japan
Frulloni, L:
Univ Verona, Pancreas Ctr, Dept Med, I-37100 Verona, Italy
Messina, O:
Univ Verona, Pancreas Ctr, Dept Med, I-37100 Verona, Italy
Levy, P:
Beaujon Hosp, AP HP, Dept Gastroenterol & Pancreatol, 100 Blvd Gen Leclerc, F-92118 Clichy, France
Green Published
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