Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas).

Autor:	Jais B; Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France., Rebours V; Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France., Malleo G; The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy., Salvia R; The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy., Fontana M; The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy., Maggino L; The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy., Bassi C; The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy., Manfredi R; The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy., Moran R; Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Lennon AM; Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Zaheer A; Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Wolfgang C; Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Hruban R; Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Marchegiani G; Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Fernández Del Castillo C; Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Brugge W; Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Ha Y; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Kim MH; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Oh D; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Hirai I; First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan., Kimura W; First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan., Jang JY; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Kim SW; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Jung W; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Kang H; Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea., Song SY; Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea., Kang CM; Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea., Lee WJ; Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea., Crippa S; Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy., Falconi M; Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy., Gomatos I; NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK., Neoptolemos J; NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK., Milanetto AC; Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy., Sperti C; Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy., Ricci C; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy., Casadei R; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy., Bissolati M; Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Balzano G; Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Frigerio I; Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy., Girelli R; Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy., Delhaye M; Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium., Bernier B; Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium., Wang H; Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China., Jang KT; Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Song DH; Department of Pathology, Gyeongsang National University School of Medicine, Jinju, Korea., Huggett MT; Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK., Oppong KW; Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK., Pererva L; National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine., Kopchak KV; National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine., Del Chiaro M; Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden., Segersvard R; Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden., Lee LS; Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Conwell D; Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Osvaldt A; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Campos V; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Aguero Garcete G; Hôpital Privé Mermoz, Gastroentérologie, Lyon, France., Napoleon B; Hôpital Privé Mermoz, Gastroentérologie, Lyon, France., Matsumoto I; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Shinzeki M; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Bolado F; Gastroenterology Department, Hospital de Navarra, Pamplona, Spain., Fernandez JM; Gastroenterology Department, Hospital de Navarra, Pamplona, Spain., Keane MG; Department of Gastroenterology and Hepatology, University College Hospital, London, UK., Pereira SP; Department of Gastroenterology and Hepatology, University College Hospital, London, UK., Acuna IA; Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain., Vaquero EC; Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain., Angiolini MR; Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy., Zerbi A; Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy., Tang J; Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia., Leong RW; Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia., Faccinetto A; Radiological Department, General Hospital Cá Foncello, Treviso, Italy., Morana G; Radiological Department, General Hospital Cá Foncello, Treviso, Italy., Petrone MC; Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy., Arcidiacono PG; Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy., Moon JH; Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea., Choi HJ; Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea., Gill RS; Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia., Pavey D; Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia., Ouaïssi M; Department of Digestive Surgery, Timone Hospital, Marseille, France., Sastre B; Department of Digestive Surgery, Timone Hospital, Marseille, France., Spandre M; Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy., De Angelis CG; Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy., Rios-Vives MA; Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain., Concepcion-Martin M; Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain., Ikeura T; The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan., Okazaki K; The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan., Frulloni L; Department of Medicine, Pancreas Center, University of Verona, Verona, Italy., Messina O; Department of Medicine, Pancreas Center, University of Verona, Verona, Italy., Lévy P; Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France.
Jazyk:	angličtina
Zdroj:	Gut [Gut] 2016 Feb; Vol. 65 (2), pp. 305-12. Date of Electronic Publication: 2015 Jun 04.
DOI:	10.1136/gutjnl-2015-309638
Abstrakt:	Objectives: Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design: Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results: 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4-140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1). Conclusions: After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. Trial Registration Number: IRB 00006477. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
Databáze:	MEDLINE
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