PMID- 21468008
OWN - NLM
STAT- MEDLINE
DCOM- 20110929
LR  - 20220318
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 106
IP  - 8
DP  - 2011 Aug
TI  - Tumor size and location correlate with behavior of pancreatic serous cystic 
      neoplasms.
PG  - 1521-6
LID - 10.1038/ajg.2011.117 [doi]
AB  - OBJECTIVES: The majority of pancreatic serous cystic neoplasms (SCNs) are benign. 
      However, these neoplasms can cause symptoms and rarely can be aggressive. 
      Identification of factors associated with symptomatic or aggressive SCNs may aid 
      management decisions. The aim of this study was to identify variables that 
      predict aggressive SCNs. METHODS: Prospective pathology database was queried for 
      SCNs that were surgically resected at Johns Hopkins Hospital. Tumors were 
      considered aggressive if they invaded surrounding structures and/or vessels or if 
      they metastasized to lymph nodes or distant organs. The associations of gender, 
      tumor size, and tumor location, with the presence or absence of symptoms and 
      tumor behavior were examined using Fisher's exact test, logistic regression, and 
      multivariate analyses. RESULTS: A total of 257 patients with SCNs underwent 
      surgical resection. Mean tumor diameter was 4.9 cm. Tumor location in the head of 
      pancreas (HOP) was associated with symptoms (odds ratio (OR) 1.87, 95% confidence 
      interval (CI) 1.1-3.3). Computed tomography (CT) predicted the diagnosis of SCN 
      in approximately a quarter of patients. Thirteen tumors (mean 10.5 cm) were 
      considered aggressive. Multivariate analysis showed that tumor diameter (OR 1.53, 
      95% CI 1.24-1.89) and location of tumor in pancreatic head (OR 10.44, 95% CI 
      1.73-63.04) were independently associated with aggressive behavior. CONCLUSIONS: 
      We describe the largest case series of patients with pathologically proven SCNs. 
      CT performed poorly in preoperative diagnosis of SCNs. Large tumor size and head 
      location predicted aggressive behavior. These factors should be considered in the 
      management of patients with SCN.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Department of Medicine and Division of Gastroenterology and Hepatology, The Sol 
      Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland 21205, USA.
FAU - Shin, Eun Ji
AU  - Shin EJ
FAU - Amateau, Stuart
AU  - Amateau S
FAU - Canto, Marcia Irene
AU  - Canto MI
FAU - Hruban, Ralph H
AU  - Hruban RH
FAU - Fishman, Elliot K
AU  - Fishman EK
FAU - Cameron, John L
AU  - Cameron JL
FAU - Edil, Barish H
AU  - Edil BH
FAU - Wolfgang, Christopher L
AU  - Wolfgang CL
FAU - Schulick, Richard D
AU  - Schulick RD
FAU - Giday, Samuel
AU  - Giday S
LA  - eng
PT  - Journal Article
DEP - 20110405
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
SB  - IM
MH  - Abdominal Pain/etiology
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Cholestasis/etiology
MH  - Cystadenoma, Serous/complications/diagnosis/diagnostic imaging/*pathology/surgery
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Jaundice/etiology
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - *Pancreatectomy/methods
MH  - Pancreatic Neoplasms/complications/diagnosis/diagnostic 
      imaging/*pathology/surgery
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sex Factors
MH  - *Tomography, X-Ray Computed
MH  - Weight Loss
EDAT- 2011/04/07 06:00
MHDA- 2011/10/01 06:00
CRDT- 2011/04/07 06:00
PHST- 2011/04/07 06:00 [entrez]
PHST- 2011/04/07 06:00 [pubmed]
PHST- 2011/10/01 06:00 [medline]
AID - ajg2011117 [pii]
AID - 10.1038/ajg.2011.117 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2011 Aug;106(8):1521-6. doi: 10.1038/ajg.2011.117. Epub 2011 
      Apr 5.