Details

Autor(en) / Beteiligte

• Malleo, Giuseppe
• Salvia, Roberto
• Bassi, Claudio
• Peng, Shu You
• Beger, Hans G
• Sarr, Michael G
• Neoptolemos, John P
• Nakao, Akimasa

Titel

Long‐Term Outcome after Observation and Surgical Treatment of Cystic Neoplasms of the Pancreas

Ist Teil von

• Pancreatic Cancer, Cystic Neoplasms and Endocrine Tumors, 2015, p.275-279

Ort / Verlag

Oxford, UK: John Wiley & Sons, Ltd

Erscheinungsjahr

2015

Quelle

Wiley Online Library All Obooks

Beschreibungen/Notizen

• The management of cystic neoplasms of the pancreas is selective and varies according to the cyst type and perceived malignant risk. Patients with serous cystic neoplasms or branch‐duct intraductal papillary mucinous neoplasms (IPMNs) devoid of clinical concern frequently are enrolled in surveillance protocols and undergo periodic, cross‐sectional imaging. Modality and frequency of follow‐up depend on the characteristics of the cystic lesion; the principal outcome metrics are morphologic transformation, development of symptoms, pancreatic carcinogenesis, and crossover to operative resection. In patients who undergo resection, either at the time of diagnosis or after a follow‐up period, long‐term outcomes (tumor recurrence and survival) depend on the cyst type and the presence of an invasive component. In general, complete resection of serous cystic neoplasms and noninvasive mucinous cystic neoplasms ensures cure. Noninvasive IPMNs and solid pseudopapillary neoplasms are associated with an excellent prognosis, although a small risk of recurrence has to be taken into account when planning treatment. The prognosis of invasive IPMN depends on many factors, the most important of which is the presence of histologic invasion. Finally, different reports suggest that patients with IPMN are at increased long‐term risk of pancreatic carcinogenesis (pancreatic ductal adenocarcinoma not arising in the background of an IPMN). In general, outcome after observation or operative resection of cystic neoplasms of the pancreas is in many aspects unclear, because long‐term follow‐up is limited and data come from retrospective and uncontrolled series.