PMID- 18564119
OWN - NLM
STAT- MEDLINE
DCOM- 20080903
LR  - 20090416
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 103
IP  - 7
DP  - 2008 Jul
TI  - Incidental cystic neoplasms of pancreas: what is the optimal interval of imaging 
      surveillance?
PG  - 1657-62
LID - 10.1111/j.1572-0241.2008.01893.x [doi]
AB  - BACKGROUND: The optimal interval of imaging studies for surveillance of 
      incidental pancreatic cystic neoplasms is not known. OBJECTIVE: A retrospective 
      analysis of longitudinal medical records of patients with pancreatic cystic 
      neoplasms was performed to examine the natural history of incidentally detected 
      cystic pancreatic neoplasms with respect to the development of significant growth 
      and to identify predictors of such growth. RESULTS: After excluding patients with 
      small (<10 mm) cysts (N = 144) and inadequate clinical follow-up of less than 6 
      months (N = 79) and those with a clinical diagnosis of pancreatic pseudocysts, 
      serous cystadenoma, main duct intraductal papillary mucinous neoplasm (N = 29), 
      and neuroendocrine tumor (N = 3), in total, 166 cysts in 150 patients were 
      available for analysis. The working diagnoses on these cysts (based on clinical, 
      radiological features, aspiration cytology, cyst fluid analysis, and surgical 
      pathology data when available) were mucinous cystic neoplasm in 117 and 
      branch-type intraductal papillary mucinous neoplasm in 49. The mean standard 
      error (SE) initial size of these cysts was 2 (0.1) cm. Over a median period of 
      follow-up of 32 (IQR [inter-quartile range] 19-48) months, 89% of all the cysts 
      did not show significant growth during the follow-up. In a multivariate Cox 
      proportional hazards model, the initial size of the cystic lesion was an 
      independent predictor of significant growth during follow-up (relative risk 1.28, 
      95% confidence interval [CI] 1.08-1.61, P= 0.01); the only other significant 
      variable was the presence of intracystic or mural nodule (relative risk 38.6, 95% 
      CI 2.3-654, P= 0.01). CONCLUSION: Most incidentally detected cystic neoplasms of 
      the pancreas did not have significant growth during follow-up. Such growth is 
      unlikely to occur before 2 yr of the baseline evaluation, and we suggest that the 
      optimal imaging interval during follow-up of these patients should be at 2 yr 
      from the baseline evaluation, particularly in cystic lesions 3.0 cm or less in 
      size and without intracystic or mural nodules.
FAU - Das, Ananya
AU  - Das A
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, 
      Arizona 85259, USA.
FAU - Wells, Christopher D
AU  - Wells CD
FAU - Nguyen, Cuong C
AU  - Nguyen CC
LA  - eng
PT  - Journal Article
DEP - 20080628
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
SB  - IM
CIN - Am J Gastroenterol. 2009 Apr;104(4):1055. PMID: 19277029
MH  - Aged
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Incidental Findings
MH  - Male
MH  - Pancreatic Cyst/*diagnosis/pathology
MH  - Pancreatic Neoplasms/*diagnosis/pathology
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 2008/06/20 09:00
MHDA- 2008/09/04 09:00
CRDT- 2008/06/20 09:00
PHST- 2008/06/20 09:00 [pubmed]
PHST- 2008/09/04 09:00 [medline]
PHST- 2008/06/20 09:00 [entrez]
AID - AJG1893 [pii]
AID - 10.1111/j.1572-0241.2008.01893.x [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2008 Jul;103(7):1657-62. doi: 
      10.1111/j.1572-0241.2008.01893.x. Epub 2008 Jun 28.