Skip to main content
Erschienen in: Digestive Diseases and Sciences 10/2007

01.10.2007 | Original Article

Outcomes of Cystic Lesions in the Pancreas After Extended Follow-up

verfasst von: Sang Hyub Lee, Cheol Min Shin, Joo Kyung Park, Sang Myung Woo, Ji Won Yoo, Ji Kon Ryu, Yong Bum Yoon, Yong-Tae Kim

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2007

Einloggen, um Zugang zu erhalten

Abstract

Incidental pancreatic cysts are frequently detected, but no appropriate management guidelines have been issued for their management because their natural history is relatively unknown. The aim of this study was to investigate their long-term clinical outcomes. Pancreatic cysts detected from 1998 to 2004 were retrospectively reviewed in patients followed up for more than 3 months. A total of 182 patients with incidental pancreatic cysts (initial mean size, 1.8±1.1 cm) underwent follow-up for an average of 35.4 months. An age≥60 years was found to be associated with an increase in cyst size, with an odds ratio of 2.56. Two malignant cysts were found among 20 patients who underwent surgical resection during follow-up. Old age was also associated with the presence of a premalignant or malignant cyst (P<0.01). Although the majority of incidental pancreatic cysts show an indolent behavior, long-term, regular follow-up studies should be considered for all pancreatic cysts, especially in the elderly.
Literatur
1.
Zurück zum Zitat Balcom IJ, Fernandez-Del Castillo C, Warshaw AL (2000) Cystic lesions in the pancreas: when to watch, when to resect. Curr Gastroenterol Rep 2:152–158CrossRef Balcom IJ, Fernandez-Del Castillo C, Warshaw AL (2000) Cystic lesions in the pancreas: when to watch, when to resect. Curr Gastroenterol Rep 2:152–158CrossRef
2.
Zurück zum Zitat Kiely JM, Nakeeb A, Komorowski RA, Wilson SD, Pitt HA (2003) Cystic pancreatic neoplasms: Enucleate or resect? J Gastrointest Surg 7:890–897PubMedCrossRef Kiely JM, Nakeeb A, Komorowski RA, Wilson SD, Pitt HA (2003) Cystic pancreatic neoplasms: Enucleate or resect? J Gastrointest Surg 7:890–897PubMedCrossRef
3.
Zurück zum Zitat Fernandez-del Castillo C, Targarona J, Thayer SP, Rattner DW, Brugge WR, Warshaw AL (2003) Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg 138:427–423, discussion 433–424PubMedCrossRef Fernandez-del Castillo C, Targarona J, Thayer SP, Rattner DW, Brugge WR, Warshaw AL (2003) Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg 138:427–423, discussion 433–424PubMedCrossRef
4.
Zurück zum Zitat Megibow AJ, Lombardo FP, Guarise A, Carbognin G, Scholes J, Rofsky NM, Macari M, Balthazar EJ, Procacci C (2001) Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging 26:640–647PubMedCrossRef Megibow AJ, Lombardo FP, Guarise A, Carbognin G, Scholes J, Rofsky NM, Macari M, Balthazar EJ, Procacci C (2001) Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging 26:640–647PubMedCrossRef
5.
Zurück zum Zitat Horvath KD, Chabot JA (1999) An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg 178:269–274PubMedCrossRef Horvath KD, Chabot JA (1999) An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg 178:269–274PubMedCrossRef
6.
Zurück zum Zitat Gasslander T, Arnelo U, Albiin N, Permert J (2001) Cystic tumors of the pancreas. Dig Dis 19:57–62PubMedCrossRef Gasslander T, Arnelo U, Albiin N, Permert J (2001) Cystic tumors of the pancreas. Dig Dis 19:57–62PubMedCrossRef
7.
Zurück zum Zitat Meyer W, Kohler J, Gebhardt C (1999) Cystic neoplasms of the pancreas—cystadenomas and cystadenocarcinomas. Langenbecks Arch Surg 384:44–49PubMedCrossRef Meyer W, Kohler J, Gebhardt C (1999) Cystic neoplasms of the pancreas—cystadenomas and cystadenocarcinomas. Langenbecks Arch Surg 384:44–49PubMedCrossRef
8.
Zurück zum Zitat Allen PJ, Jaques DP, D’Angelica M, Bowne WB, Conlon KC, Brennan MF (2003) Cystic lesions of the pancreas: selection criteria for operative and nonoperative management in 209 patients. J Gastrointest Surg 7:970–977PubMedCrossRef Allen PJ, Jaques DP, D’Angelica M, Bowne WB, Conlon KC, Brennan MF (2003) Cystic lesions of the pancreas: selection criteria for operative and nonoperative management in 209 patients. J Gastrointest Surg 7:970–977PubMedCrossRef
9.
Zurück zum Zitat Suzuki Y, Atomi Y, Sugiyama M, Isaji S, Inui K, Kimura W, Sunamura M, Furukawa T, Yanagisawa A, Ariyama J, Takada T, Watanabe H, Suda K (2004) Cystic neoplasm of the pancreas: a Japanese multiinstitutional study of intraductal papillary mucinous tumor and mucinous cystic tumor. Pancreas 28:241–246PubMedCrossRef Suzuki Y, Atomi Y, Sugiyama M, Isaji S, Inui K, Kimura W, Sunamura M, Furukawa T, Yanagisawa A, Ariyama J, Takada T, Watanabe H, Suda K (2004) Cystic neoplasm of the pancreas: a Japanese multiinstitutional study of intraductal papillary mucinous tumor and mucinous cystic tumor. Pancreas 28:241–246PubMedCrossRef
10.
Zurück zum Zitat Harper AE, Eckhauser FE, Mulholland MW (2002) Resectional therapy for cystic neoplasms of the pancreas. Am Surg 68:353–357, discussion 357–358PubMed Harper AE, Eckhauser FE, Mulholland MW (2002) Resectional therapy for cystic neoplasms of the pancreas. Am Surg 68:353–357, discussion 357–358PubMed
11.
Zurück zum Zitat Spinelli KS, Fromwiller TE, Daniel RA, Kiely JM, Nakeeb A, Komorowski RA, Wilson SD, Pitt HA (2004) Cystic pancreatic neoplasms: observe or operate. Ann Surg 239:651–657PubMedCrossRef Spinelli KS, Fromwiller TE, Daniel RA, Kiely JM, Nakeeb A, Komorowski RA, Wilson SD, Pitt HA (2004) Cystic pancreatic neoplasms: observe or operate. Ann Surg 239:651–657PubMedCrossRef
12.
Zurück zum Zitat Talamini MA, Pitt HA, Hruban RH, Boitnott JK, Coleman J, Cameron JL (1992) Spectrum of cystic tumors of the pancreas. Am J Surg 163:117–123, discussion 123–114PubMedCrossRef Talamini MA, Pitt HA, Hruban RH, Boitnott JK, Coleman J, Cameron JL (1992) Spectrum of cystic tumors of the pancreas. Am J Surg 163:117–123, discussion 123–114PubMedCrossRef
13.
Zurück zum Zitat Talamini MA, Moesinger R, Yeo CJ, Poulose B, Hruban RH, Cameron JL, Pitt HA (1998) Cystadenomas of the pancreas: Is enucleation an adequate operation? Ann Surg 227:896–903PubMedCrossRef Talamini MA, Moesinger R, Yeo CJ, Poulose B, Hruban RH, Cameron JL, Pitt HA (1998) Cystadenomas of the pancreas: Is enucleation an adequate operation? Ann Surg 227:896–903PubMedCrossRef
14.
Zurück zum Zitat Moesinger RC, Talamini MA, Hruban RH, Cameron JL, Pitt HA (1999) Large cystic pancreatic neoplasms: pathology, resectability, and outcome. Ann Surg Oncol 6:682–690PubMedCrossRef Moesinger RC, Talamini MA, Hruban RH, Cameron JL, Pitt HA (1999) Large cystic pancreatic neoplasms: pathology, resectability, and outcome. Ann Surg Oncol 6:682–690PubMedCrossRef
15.
Zurück zum Zitat Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR (1990) Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg 212:432–443, discussion 444–435PubMedCrossRef Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR (1990) Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg 212:432–443, discussion 444–435PubMedCrossRef
16.
Zurück zum Zitat Ikeda M, Sato T, Ochiai M, Morozumi A, Ainota T, Fujino MA (1993) Ultrasonographic follow-up study of small pancreatic cysts of unknown etiology. Bildgebung 60:209–214PubMed Ikeda M, Sato T, Ochiai M, Morozumi A, Ainota T, Fujino MA (1993) Ultrasonographic follow-up study of small pancreatic cysts of unknown etiology. Bildgebung 60:209–214PubMed
17.
Zurück zum Zitat Sahani DV, Saokar A, Hahn PF, Brugge WR, Fernandez-Del Castillo C (2006) Pancreatic cysts 3 cm or smaller: how aggressive should treatment be? Radiology 238:912–919PubMedCrossRef Sahani DV, Saokar A, Hahn PF, Brugge WR, Fernandez-Del Castillo C (2006) Pancreatic cysts 3 cm or smaller: how aggressive should treatment be? Radiology 238:912–919PubMedCrossRef
18.
Zurück zum Zitat Walsh RM, Vogt DP, Henderson JM, Zuccaro G, Vargo J, Dumot J, Herts B, Biscotti CV, Brown N (2005) Natural history of indeterminate pancreatic cysts. Surgery 138:665–670, discussion 670–671PubMedCrossRef Walsh RM, Vogt DP, Henderson JM, Zuccaro G, Vargo J, Dumot J, Herts B, Biscotti CV, Brown N (2005) Natural history of indeterminate pancreatic cysts. Surgery 138:665–670, discussion 670–671PubMedCrossRef
19.
Zurück zum Zitat Handrich SJ, Hough DM, Fletcher JG, Sarr MG (2005) The natural history of the incidentally discovered small simple pancreatic cyst: long-term follow-up and clinical implications. AJR Am J Roentgenol 184:20–23PubMed Handrich SJ, Hough DM, Fletcher JG, Sarr MG (2005) The natural history of the incidentally discovered small simple pancreatic cyst: long-term follow-up and clinical implications. AJR Am J Roentgenol 184:20–23PubMed
20.
Zurück zum Zitat Le Borgne J, de Calan L, Partensky C (1999) Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association. Ann Surg 230:152–161PubMedCrossRef Le Borgne J, de Calan L, Partensky C (1999) Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association. Ann Surg 230:152–161PubMedCrossRef
21.
Zurück zum Zitat Sarr MG, Kendrick ML, Nagorney DM, Thompson GB, Farley DR, Farnell MB (2001) Cystic neoplasms of the pancreas: ben ign to malignant epithelial neoplasms. Surg Clin North Am 81:497–509PubMedCrossRef Sarr MG, Kendrick ML, Nagorney DM, Thompson GB, Farley DR, Farnell MB (2001) Cystic neoplasms of the pancreas: ben ign to malignant epithelial neoplasms. Surg Clin North Am 81:497–509PubMedCrossRef
22.
Zurück zum Zitat Jang JY, Kim SW, Ahn YJ, Yoon YS, Choi MG, Lee KU, Han JK, Kim WH, Lee YJ, Kim SC, Han DJ, Kim YI, Choi SH, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee KB, Kim YC, Lee KS, Kim MW, Kim HJ, Kim HJ, Park YH (2005) Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: Is it possible to predict the malignancy before surgery? Ann Surg Oncol 12:124–132PubMedCrossRef Jang JY, Kim SW, Ahn YJ, Yoon YS, Choi MG, Lee KU, Han JK, Kim WH, Lee YJ, Kim SC, Han DJ, Kim YI, Choi SH, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee KB, Kim YC, Lee KS, Kim MW, Kim HJ, Kim HJ, Park YH (2005) Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: Is it possible to predict the malignancy before surgery? Ann Surg Oncol 12:124–132PubMedCrossRef
23.
Zurück zum Zitat Sohn TA, Yeo CJ, Cameron JL, Iacobuzio-Donahue CA, Hruban RH, Lillemoe KD (2001) Intraductal papillary mucinous neoplasms of the pancreas: an increasingly recognized clinicopathologic entity. Ann Surg 234:313–321, discussion 321–312PubMedCrossRef Sohn TA, Yeo CJ, Cameron JL, Iacobuzio-Donahue CA, Hruban RH, Lillemoe KD (2001) Intraductal papillary mucinous neoplasms of the pancreas: an increasingly recognized clinicopathologic entity. Ann Surg 234:313–321, discussion 321–312PubMedCrossRef
24.
Zurück zum Zitat Chari ST, Yadav D, Smyrk TC, DiMagno EP, Miller LJ, Raimondo M, Clain JE, Norton IA, Pearson RK, Petersen BT, Wiersema MJ, Farnell MB, Sarr MG (2002) Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. Gastroenterology 123:1500–1507PubMedCrossRef Chari ST, Yadav D, Smyrk TC, DiMagno EP, Miller LJ, Raimondo M, Clain JE, Norton IA, Pearson RK, Petersen BT, Wiersema MJ, Farnell MB, Sarr MG (2002) Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. Gastroenterology 123:1500–1507PubMedCrossRef
25.
Zurück zum Zitat Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L (2002) Pancreatic cysts: depiction on single-shot fast spin-echo MR images. Radiology 223:547–553PubMedCrossRef Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L (2002) Pancreatic cysts: depiction on single-shot fast spin-echo MR images. Radiology 223:547–553PubMedCrossRef
26.
Zurück zum Zitat Curry CA, Eng J, Horton KM, Urban B, Siegelman S, Kuszyk BS, Fishman EK (2000) CT of primary cystic pancreatic neoplasms: Can CT be used for patient triage and treatment? AJR Am J Roentgenol 175:99–103PubMed Curry CA, Eng J, Horton KM, Urban B, Siegelman S, Kuszyk BS, Fishman EK (2000) CT of primary cystic pancreatic neoplasms: Can CT be used for patient triage and treatment? AJR Am J Roentgenol 175:99–103PubMed
27.
Zurück zum Zitat Centeno BA (2002) Role of cytology in the diagnosis of cystic and intraductal papillary mucinous neoplasms. Gastrointest Endosc Clin N Am 12:697–708PubMedCrossRef Centeno BA (2002) Role of cytology in the diagnosis of cystic and intraductal papillary mucinous neoplasms. Gastrointest Endosc Clin N Am 12:697–708PubMedCrossRef
28.
Zurück zum Zitat Recine M, Kaw M, Evans DB, Krishnamurthy S (2004) Fine-needle aspiration cytology of mucinous tumors of the pancreas. Cancer 102:92–99PubMedCrossRef Recine M, Kaw M, Evans DB, Krishnamurthy S (2004) Fine-needle aspiration cytology of mucinous tumors of the pancreas. Cancer 102:92–99PubMedCrossRef
29.
Zurück zum Zitat Sarr MG, Murr M, Smyrk TC, Yeo CJ, Fernandez-del-Castillo C, Hawes RH, Freeny PC (2003) Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions. J Gastrointest Surg 7:417–428PubMedCrossRef Sarr MG, Murr M, Smyrk TC, Yeo CJ, Fernandez-del-Castillo C, Hawes RH, Freeny PC (2003) Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions. J Gastrointest Surg 7:417–428PubMedCrossRef
Metadaten
Titel
Outcomes of Cystic Lesions in the Pancreas After Extended Follow-up
verfasst von
Sang Hyub Lee
Cheol Min Shin
Joo Kyung Park
Sang Myung Woo
Ji Won Yoo
Ji Kon Ryu
Yong Bum Yoon
Yong-Tae Kim
Publikationsdatum
01.10.2007
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2007
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-006-9634-y

Weitere Artikel der Ausgabe 10/2007

Digestive Diseases and Sciences 10/2007 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.