Produção Nacional
Revisado por pares
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)
2015; BMJ; Volume: 65; Issue: 2 Linguagem: Inglês
10.1136/gutjnl-2015-309638
ISSN1468-3288
AutoresBénédicte Jaïs, Vinciane Rebours, Giuseppe Malleo, Roberto Salvia, M. Fontana, Laura Maggino, Claudio Bassi, Riccardo Manfredi, Robert A. Moran, Anne Marie Lennon, Atif Zaheer, Christopher L. Wolfgang, Ralph H. Hruban, Giovanni Marchegiani, Carlos Fernández del Castillo, William R. Brugge, Yeonjung Ha, M. H. Kim, Dongwook Oh, Ichiro Hirai, Wataru Kimura, Jin‐Young Jang, S W Kim, Woohyun Jung, Huapyong Kang, Si Young Song, Chang Moo Kang, W J Lee, Stefano Crippa, Massimo Falconi, Ilias P. Gomatos, John P. Neoptolemos, Anna Caterina Milanetto, Cosimo Sperti, Claudio Ricci, Riccardo Casadei, Massimiliano Bissolati, Gianpaolo Balzano, Isabella Frigerio, R. Girelli, Myriam Delhaye, Benjamin Bernier, H Wang, Kee‐Taek Jang, Dae Hyun Song, Matthew T. Huggett, Kofi Oppong, L. Pererva, Kopchak Kv, Marco Del Chiaro, Ralf Segersvärd, L S Lee, Darwin L. Conwell, Alessandro Bersch Osvaldt, Vinicius J. Campos, G Aguero Garcete, Bertrand Napoléon, Ippei Matsumoto, Makoto Shinzeki, Federico Bolado, Jesús Urmán, Margaret G. Keane, Stephen P. Pereira, Isis K. Araujo, Eva C. Vaquero, Maria Rachele Angiolini, Alessandro Zerbi, James Tang, Rupert W. Leong, Alex Faccinetto, Giovanni Morana, Maria Chiara Petrone, Paolo Giorgio Arcidiacono, Jong Ho Moon, Hyun Jong Choi, R S Gill, Darren Pavey, Mehdi Ouaïssi, B. Sastre, M. Spandre, C.G. De Angelis, Miguel Ángel Ríos-Vives, Mar Concepción-Martín, Tsukasa Ikeura, Kazuichi Okazaki, Luca Frulloni, O. Messina, Pierre Lévy,
Tópico(s)Gastrointestinal disorders and treatments
ResumoObjectives 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 SCN9s 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.
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