Risk Factors for Pancreatic Cancer and the Necessity of Long-Term Surveillance in Patients With Pancreatic Cystic Lesions. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Yoshioka, Teppei; Shigekawa, Minoru; Ikezawa, Kenji; Tamura, Takeshi; Sato, Katsuhiko; Urabe, Makiko; Sueyoshi, Hironari; Yamai, Takuo; Suda, Takahiro; Sakamori, Ryotaro; Tatsumi, Tomohide; Takehara, Tetsuo
• Is Part Of: Pancreas. Volume 49:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: pancreatic cystic lesions -- pancreatic cancer; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001521
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: Pancreatic cystic lesions (PCLs) are a risk factor for pancreatic cancer (PC). Which PCLs should be surveilled and necessity of long-term observation are still controversial. Methods: From January 2000 to March 2016, we enrolled 1137 patients with PCLs observed for 1 year. We defined PCLs with cyst size of greater than 30 mm, main pancreatic duct (MPD) of greater than 5 mm or mural nodule as high-risk group, and others as low-risk group (LRG). Kaplan-Meier method and Cox proportional hazard model were applied to assess incidence and risk factors of PC. Results: In 107 high-risk group and 1030 LRG patients, mean observation period was 4.3 years and 5.0 years, respectively, and 5-year PC incidence was 12.0% and 2.8%, respectively. In LRG, MPD of greater than 3 mm, diabetes mellitus, and presumed branch-duct intraductal papillary mucinous neoplasia (BD-IPMN), defined as PCLs fulfilling any of multilocular formation, multiplicity, or MPD communication, were independent risk factors for PC. In 450 LRG observed for 5 years, 10-year PC incidence was higher in PCLs with our identified risk factors. There was no PC occurrence in PCLs not presumed BD-IPMN after 5-year observation. Conclusions: Continuous surveillance is needed after 5-year observation, especially in LRG with our identified risk factors. For discontinuing surveillance, PCLs not presumed BD-IPMN at fifth year could be candidates. Abstract : Supplemental digital content is available in the text.