Close follow-up needed in patients with pancreatic cysts
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High incidence of malignant transformation in patients with pancreatic cysts confirms the need for close follow-up, according to a presentation at the American College of Gastroenterology Virtual Annual Scientific Meeting.
“The post-operative course of patients with surgically excised pancreatic cysts (PC) are limited. ... The current guideline recommendations on post-operative surveillance are variable and are based on variable quality of evidence,” Mohannad Abou Saleh, MD, Cleveland Clinic, said. “This prompted us to pursue this project with the aim to describe the post-operative course of PC patients and evaluate the rates and predictors of recurrences high risk and malignant transformation.”
In a prospectively maintained database, researchers analyzed 100 diagnosed cases of PC for outcomes of recurrent cysts, rate of growth, high-risk transformation and malignant transformation. Researchers used Kaplan-Meier estimates and Cox proportional hazards as well as mixed effect logistic regression models to evaluate increased growth over time; univariable and multivariable analyses evaluated predictors of measured outcomes. Follow-up occurred at 1-year, 3-years and 5-years.
Study results showed the incidence of measured outcomes increased over time with 34.5% recurrence at 1-year vs. 64.8% recurrence at 5-years, 5.1% high-risk transformation at 1-year vs. 13.7% high-risk transformation at 5-years and 11.7% malignant transformation at 1-year vs. 19% malignant transformation at 5-years. Further analysis showed an overall mortality rate of 13.5% with 5.8% of deaths related to pancreatic etiology. Researchers found no statistically significant predictors of measured outcomes.
“The high incidence of malignant transformation confirms the need for close follow up and continued surveillance of PC patients with remnant pancreas,” Saleh concluded. “Mucinous cystic neoplasms seem to have low incidence of malignant and high-risk transformation, which supports the recommendation of no further surveillance post operatively if no malignancy is present.”
Saleh MA, et al. Presentation 13. Presented at: The American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 26-28, 2020.
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Saleh MA, et al. Presentation 13. Presented at: The American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 26-28, 2020.
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