This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Risk of malignancy in resected pancreatic mucinous cystic neoplasms. BJS 2018; 105: 439-446.
Published: 28th February 2018
Authors: M. G. Keane, A. Shamali, L. N. Nilsson, A. Antila, J. Millastre Bocos, M. Marijinissen Van Zanten et al.
Background
Pancreatic mucinous cystic neoplasms (MCNs) are rare mucin‐producing cystic tumours defined by the presence of ovarian‐type stroma. MCNs have a malignant potential and thus surgery is frequently performed. The aim of this cohort study was to define better the criteria for surgical resection in patients with MCN.
Method
This multicentre retrospective study included all resected MCNs between 2003 and 2015 in participating centres. Lesions without ovarian‐type stroma were excluded. Patient characteristics, preoperative findings, histopathology findings and follow‐up data were recorded.
Results
The study included 211 patients; their median age was 53 (range 18–82) years, and 202 (95·7 per cent) were women. Median preoperative tumour size was 55 (range 12–230) mm. Thirty‐four of the 211 (16·1 per cent) were malignant, and high‐grade dysplasia (HGD) was found in a further 13 (6·2 per cent). One‐third of MCNs in men were associated with invasive cancer, compared with 15·3 per cent in women. Five cases of malignant transformation occurred in MCNs smaller than 4 cm. All cases of malignancy or HGD were associated with symptoms or features of concern on preoperative cross‐sectional imaging. In multivariable analysis, raised carbohydrate antigen 19‐9 (odds ratio (OR) 10·54, 95 per cent c.i. 2·85 to 218·23;
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