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Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards—a multi-center retrospective study from China

  
@article{ATM33728,
	author = {Wenchuan Wu and Ji Li and Ning Pu and Gang Li and Xin Wang and Gang Zhao and Lei Wang and Xiaodong Tian and Chunhui Yuan and Yi Miao and Kuirong Jiang and Jun Cao and Xiaowu Xu and Xueli Bai and Yongsheng Yang and Fubao Liu and Xuewei Bai and Rui Kong and Zheng Wang and Deliang Fu and Wenhui Lou and Chinese Young Surgeon Study Group in Pancreatic Surgery},
	title = {Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards—a multi-center retrospective study from China},
	journal = {Annals of Translational Medicine},
	volume = {7},
	number = {24},
	year = {2019},
	keywords = {},
	abstract = {Background: Serous cystic neoplasms (SCN) rarely have malignant potential, so accurate diagnosis of SCN is crucial for proper clinical management, especially to avoid unnecessary surgeries. However, the misdiagnosis of other pancreatic cystic neoplasm instead of SCN may highly increase the risk of malignancy in patients who receive no surgery.
Methods: Data from a total of 678 patients with pathologically confirmed to have SCN at sixteen institutions in China from January 1st, 2006 to December 31st, 2016 were retrieved to evaluate the malignancy risk of SCN.
Results: Among the 678 patients confirmed to have SCN with postoperative pathologic analysis, 649 patients (95.7%) had only one lesion and the average maximum diameter was 3.8±2.47 cm. Four patients were pathologically verified as having serous cystadenocarcinoma, so the SCN actual malignancy rate was 0.6%, while the mortality due to pancreatic surgery in these high-volume centers was nearly 0.2–2%. However, among the 99 SCN patients based on preoperative radiology, three were confirmed to have intraductal papillary mucinous neoplasms (IPMN), nine as mucinous cystic neoplasms (MCN), and four as solid pseudopapillary tumors (SPT) after postoperative pathological analysis. Thus, the total theoretical malignancy rate resulting from preoperative misdiagnosis was elevated to approximately 2.9%, higher than the risk of perioperative mortality.
Conclusions: When SCN can’t be accurately distinguished from cystic tumors of pancreas, the malignant risk of cystic tumors may be higher than perioperative risk. However, if it can be diagnosed as SCN accurately, surgery can be avoided as well.},
	issn = {2305-5847},	url = {https://atm.amegroups.org/article/view/33728}
}