Gut and Liver

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Long-Term Outcome of Cystic Lesions in the Pancreas: A Retrospective Cohort Study

Dong-Won Ahn*,, Sang Hyub Lee*,, Jaihwan Kim*, Won Jae Yoon*, Jin-Hyeok Hwang*,, Jin-Young Jang, Ji Kon Ryu*, Yong-Tae Kim*, Sun-Whe Kim, and Yong Bum Yoon*
*Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, and Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background/Aims: The management guidelines for cystic lesions of the pancreas (CLPs) are not yet well established. This study was performed to document the long-term clinical outcome of CLPs and provide guidelines for the management and surveillance of CLPs.
Methods: In this retrospective cohort study, an additional follow-up was performed in 112 patients with CLPs enrolled from 1998 to 2004 during a previous study.
Results: During follow-up for the median period of 72.3 months, the size of the CLPs increased in 18 patients (16.1%). Six of these patients experienced growth of their CLPs after 5 years of follow-up. Twenty-six patients underwent surgery during follow-up, and four malignant cysts were detected. The overall rate of malignant progression during follow-up was 3.6%. The presence of mural nodules or solid components was independently associated with the presence of malignant CLPs. Seven patients underwent surgery after 5 years of follow-up. The pathologic findings revealed malignancies in two patients. There was only one pancreas-related death during follow-up.
Conclusions: The majority of CLPs exhibit indolent behavior and are associated with a favorable prognosis. However, long-term surveillance for more than 5 years should be performed because of the potential for growth and malignant transformation in CLPs. (Gut Liver 2012;6:493-500)
Pancreatic cyst; Natural history; Prognosis
Gut and Liver 2012 Oct; 6(4): 493-500
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