PMID- 21940725
OWN - NLM
STAT- MEDLINE
DCOM- 20120727
LR  - 20191210
IS  - 1468-3288 (Electronic)
IS  - 0017-5749 (Linking)
VI  - 61
IP  - 5
DP  - 2012 May
TI  - Growth pattern of serous cystic neoplasms of the pancreas: observational study 
      with long-term magnetic resonance surveillance and recommendations for treatment.
PG  - 746-51
LID - 10.1136/gutjnl-2011-300297 [doi]
AB  - BACKGROUND AND AIMS: The natural history and growth pattern of pancreatic serous 
      cystic neoplasms (SCNs) are not well understood. This study was designed in order 
      to get insight into the growth rate of SCNs and to suggest recommendations for 
      their management. METHODS: Patients with well-documented incidentally discovered 
      or minimally symptomatic SCNs who underwent yearly surveillance MRI were analysed 
      using a linear mixed model. The growth rate and the effects of different fixed 
      factors (sex, personal history of other non-pancreatic malignancies, radiological 
      pattern, clinical presentation, tumour site) and random factors (age and tumour 
      diameter at the time of diagnosis) on tumour growth were investigated. RESULTS: 
      Study population consisted of 145 patients. Estimated overall mean growth rate 
      was 0.28 cm/year, but the growth curve analysis showed a different trend between 
      the first 7 years after the baseline evaluation (growth rate of 0.1 cm/year) and 
      the subsequent period (years 7 to 10, growth rate of 0.6 cm/year, p<0.0001). 
      Tests for fixed effects demonstrated that an oligocystic/macrocystic pattern and 
      a personal history of other tumours are significant predictors of a more rapid 
      mean tumour growth (p<0.0001 and 0.022, growth rates of 0.34 cm/year). 
      Furthermore, tumour growth significantly increased with age (p = 0.0001). 
      CONCLUSION: Overall, SCNs grow slowly, and an initial non-operative approach is 
      feasible in all the asymptomatic or minimally symptomatic patients. The 
      oligocystic/macrocystic variant, a history of other non-pancreatic malignancies 
      and patients' age impact on tumour growth. In any case, a significant growth is 
      unlikely to occur before 7 years from the baseline evaluation. Tumour size at the 
      time of diagnosis should not be used for decisional purposes.
FAU - Malleo, Giuseppe
AU  - Malleo G
AD  - Department of Surgery, General Surgery B, GB Rossi Hospital, Ple LA Scuro 10, 
      37134 Verona, Italy.
FAU - Bassi, Claudio
AU  - Bassi C
FAU - Rossini, Roberto
AU  - Rossini R
FAU - Manfredi, Riccardo
AU  - Manfredi R
FAU - Butturini, Giovanni
AU  - Butturini G
FAU - Massignani, Marta
AU  - Massignani M
FAU - Paini, Marina
AU  - Paini M
FAU - Pederzoli, Paolo
AU  - Pederzoli P
FAU - Salvia, Roberto
AU  - Salvia R
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20110922
PL  - England
TA  - Gut
JT  - Gut
JID - 2985108R
SB  - IM
MH  - Aged
MH  - Cystadenoma, Serous/*pathology/therapy
MH  - Female
MH  - Humans
MH  - Linear Models
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Neoplasms/*pathology/therapy
MH  - Population Surveillance
MH  - *Tumor Burden
EDAT- 2011/09/24 06:00
MHDA- 2012/07/28 06:00
CRDT- 2011/09/24 06:00
PHST- 2011/09/24 06:00 [entrez]
PHST- 2011/09/24 06:00 [pubmed]
PHST- 2012/07/28 06:00 [medline]
AID - gutjnl-2011-300297 [pii]
AID - 10.1136/gutjnl-2011-300297 [doi]
PST - ppublish
SO  - Gut. 2012 May;61(5):746-51. doi: 10.1136/gutjnl-2011-300297. Epub 2011 Sep 22.