New onset diabetes predicts progression of low risk pancreatic mucinous cysts
| Autor: | Christian Brooks, Adam B Schweber, John A. Chabot, Michael D. Kluger, Emil Agarunov, Amrita Sethi, John M. Poneros, Beth Schrope, Tamas A Gonda |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Population Gastroenterology Risk Assessment Diabetes Complications 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Pancreatic cancer medicine Humans Cyst education Aged Retrospective Studies Aged 80 and over education.field_of_study Hepatology Proportional hazards model business.industry Cancer Middle Aged medicine.disease Prognosis Pancreatic Neoplasms 030220 oncology & carcinogenesis Cohort Disease Progression Biomarker (medicine) 030211 gastroenterology & hepatology Female Pancreatic Cyst business |
| Zdroj: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]. 20(8) |
| ISSN: | 1424-3911 |
| Popis: | Patients with low-risk lesions require ongoing surveillance since the rate of progression to pancreatic cancer (PC), while small, is much greater than in the general population. Our objective was to study the relationship between new onset diabetes (NODM) and progression in patients with low risk mucinous cysts.We evaluated a prospectively maintained cohort of 442 patients with a suspected mucinous cyst without worrisome features (WF) or high-risk stigmata (HRS). Multivariable Cox models were developed for progression to WF and HRS, with diabetes status formulated as both time independent and dependent covariates. The adjusted cumulative risk of progression was calculated using the corrected group prognosis method.The 5-year cumulative progression rates to WFs and HRS were 12.8 and 3.6%, respectively. After controlling for other risk factors, the development of NODM was strongly associated with progression to HRS (HR = 11.6; 95%CI, 3.5-57.7%), but not WF. Among patients with the smallest cysts (10 mm) at baseline, those who developed NODM had a 5-year adjusted cumulative risk of progression to HRS of 8.6% (95%CI, 0.0%-20.2%), compared to only 0.8% (95%CI, 0.0%-2.3%) for patients without NODM. Among patients with the largest cysts (20-29 mm), those who developed NODM during surveillance had a 5-year adjusted cumulative risk of progression of 53.5% (95%CI, 19.6%-89.9%) compared to only 7.5% (95%CI, 1.6%-15.2%) for patients without NODM.New onset diabetes may predict progression in patients with low risk mucinous cysts. Pending validation with large-scale studies, these findings support regular diabetes screening among patients surveilled for suspected IPMNs or MCNs. |
| Databáze: | OpenAIRE |
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