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Wu W, Li J, Pu N, et al. Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards-a multi-center retrospective study from China. Ann Transl Med. 2019;7(24):807doi: 10.21037/atm.2019.12.70.
Wu, W., Li, J., Pu, N., Li, G., Wang, X., Zhao, G., Wang, L., Tian, X., Yuan, C., Miao, Y., Jiang, K., Cao, J., Xu, X., Bai, X., Yang, Y., Liu, F., Bai, X., Kong, R., Wang, Z., Fu, D., Lou, W. (2019). Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards-a multi-center retrospective study from China. Annals of translational medicine, 7(24), 807. https://doi.org/10.21037/atm.2019.12.70
Wu, Wenchuan, et al. "Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards-a multi-center retrospective study from China." Annals of translational medicine vol. 7,24 (2019): 807. doi: https://doi.org/10.21037/atm.2019.12.70
Wu W, Li J, Pu N, Li G, Wang X, Zhao G, Wang L, Tian X, Yuan C, Miao Y, Jiang K, Cao J, Xu X, Bai X, Yang Y, Liu F, Bai X, Kong R, Wang Z, Fu D, Lou W. Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards-a multi-center retrospective study from China. Ann Transl Med. 2019 Dec;7(24):807. doi: 10.21037/atm.2019.12.70. PMID: 32042823; PMCID: PMC6989871.
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Ann Transl Med. 2019 Dec;7(24):807. doi: 10.21037/atm.2019.12.70.

Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards-a multi-center retrospective study from China.

Annals of translational medicine

Wenchuan Wu, Ji Li, Ning Pu, Gang Li, Xin Wang, Gang Zhao, Lei Wang, Xiaodong Tian, Chunhui Yuan, Yi Miao, Kuirong Jiang, Jun Cao, Xiaowu Xu, Xueli Bai, Yongsheng Yang, Fubao Liu, Xuewei Bai, Rui Kong, Zheng Wang, Deliang Fu, Wenhui Lou,

Affiliations

  1. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  2. Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
  3. Department of General Surgery, Changhai Hospital, Naval Medicine University, Shanghai 200433, China.
  4. Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  5. Department of General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
  6. Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China.
  7. Department of General Surgery, Peking University First Hospital, Beijing 100034, China.
  8. Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
  9. Pancreatic Center & Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
  10. Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
  11. Department of General Surgery, Zhejiang Provincial People's Hospital of Hangzhou Medical College, Hangzhou 310014, China.
  12. Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
  13. Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Jilin University, Changchun 130022, China.
  14. Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
  15. Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China.
  16. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.

PMID: 32042823 PMCID: PMC6989871 DOI: 10.21037/atm.2019.12.70

Abstract

BACKGROUND: Serous cystic neoplasms (SCN) rarely have malignant potential, so accurate diagnosis of SCN is crucial for proper clinical management, especially to avoid unnecessary surgeries. However, the misdiagnosis of other pancreatic cystic neoplasm instead of SCN may highly increase the risk of malignancy in patients who receive no surgery.

METHODS: Data from a total of 678 patients with pathologically confirmed to have SCN at sixteen institutions in China from January 1

RESULTS: Among the 678 patients confirmed to have SCN with postoperative pathologic analysis, 649 patients (95.7%) had only one lesion and the average maximum diameter was 3.8±2.47 cm. Four patients were pathologically verified as having serous cystadenocarcinoma, so the SCN actual malignancy rate was 0.6%, while the mortality due to pancreatic surgery in these high-volume centers was nearly 0.2-2%. However, among the 99 SCN patients based on preoperative radiology, three were confirmed to have intraductal papillary mucinous neoplasms (IPMN), nine as mucinous cystic neoplasms (MCN), and four as solid pseudopapillary tumors (SPT) after postoperative pathological analysis. Thus, the total theoretical malignancy rate resulting from preoperative misdiagnosis was elevated to approximately 2.9%, higher than the risk of perioperative mortality.

CONCLUSIONS: When SCN can't be accurately distinguished from cystic tumors of pancreas, the malignant risk of cystic tumors may be higher than perioperative risk. However, if it can be diagnosed as SCN accurately, surgery can be avoided as well.

2019 Annals of Translational Medicine. All rights reserved.

Keywords: Serous cystic neoplasm; malignancy; risk; surgical treatment

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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