Vanishing Pancreatic Cysts during Follow-Up: Another Step Towards De-Emphasizing Cyst Size as a Major Clinical Predictor of Malignancy

2017 ◽  
Vol 35 (6) ◽  
pp. 508-513 ◽  
Author(s):  
Giovanni Marchegiani ◽  
Stefano Andrianello ◽  
Giampaolo Perri ◽  
Deborah Bonamini ◽  
Riccardo De Robertis ◽  
...  
Keyword(s):  
Pancreatic Cysts ◽  
Cyst Size ◽  
Clinical Predictor

scholarly journals Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study

Gut ◽  
2017 ◽  
Vol 67 (1) ◽  
pp. 138-145 ◽  
Author(s):  
Marie-Luise Kromrey ◽  
Robin Bülow ◽  
Jenny Hübner ◽  
Christin Paperlein ◽  
Markus M Lerch ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Maximum Size ◽  
Population Based ◽  
Pancreatic Cysts ◽  
Cyst Size ◽  
Population Based Study ◽  
Epidemiological Risk ◽  
Weighted Prevalence ◽  
Related Mortality

ObjectiveTo analyse the prevalence, incidence and clinical relevance of pancreatic cysts detected as incidental finding in a population-based longitudinal study.DesignA total of 1077 participants (521 men, mean age 55.8±12.8 years) of 2333 participants from the population-based Study of Health in Pomerania (SHIP) underwent magnetic resonance cholangiopancreaticography (MRCP) at baseline (2008–2012). MRCP was analysed for pancreatic cysts with a diameter ≥2 mm. 676/1077 subjects received a 5-year follow-up (2014–2016). The prevalence and incidence of pancreatic cysts (weighted for study participation) were assessed in association to age, gender and suspected epidemiological risk factors. Mortality follow-up was performed in 2015 for all SHIP participants (mean follow-up period 5.9 years, range 3.2–7.5 years).ResultsAt baseline pancreatic cysts had a weighted prevalence of 49.1%, with an average number of 3.9 (95% CI 3.2 to 4.5) cysts per subject in the subgroup harbouring cysts. Cyst size ranged from 2 to 29 mm. Prevalence (p<0.001), number (p=0.001) and maximum size (p<0.001) increased significantly with age. The 5-year follow-up revealed a weighted incidence of 12.9% newly detected pancreatic cysts. 57.1% of the subjects initially harbouring pancreatic cysts showed an increase in number and/or maximum cyst size. Of all subjects undergoing MRCP, no participant died of pancreatic diseases within mortality follow-up.ConclusionThe prevalence of pancreatic cysts in the general population is unexpectedly high, and their number and size increase with age. Overall, no pancreatic cancer was observed in this collective during a 5-year follow-up. Nevertheless, prospective follow-up imaging showed minimal progress in more than 50%. Only about 6% of cysts and 2.5% of the study group initially presented with cysts of more than 1 cm and thus might be clinically meaningful.

Long-term outcomes after endoscopic ultrasound-guided ablation of pancreatic cysts

Endoscopy ◽  
2017 ◽  
Vol 49 (09) ◽  
pp. 866-873 ◽  
Author(s):  
Jun-Ho Choi ◽  
Dong Seo ◽  
Tae Song ◽  
Do Park ◽  
Sang Lee ◽  
...  
Keyword(s):  
Treatment Response ◽  
Endoscopic Ultrasound ◽  
Complete Resolution ◽  
Pancreatic Cysts ◽  
Long Term Outcomes ◽  
Cyst Size ◽  
Cystic Neoplasms ◽  
Partial Resolution

Abstract Background and study aims The aim of this study was to investigate the long-term outcomes after endoscopic ultrasound (EUS)-guided pancreatic cyst ablation. Patients and methods In a single-center, prospective study, 164 patients with pancreatic cysts underwent EUS-guided cyst ablation using ethanol with paclitaxel. The inclusion criteria were as follows: unilocular or oligolocular cysts; clinically indeterminate cysts that required EUS fine-needle aspiration; and/or cysts that grew during the observation period. Treatment response was classified as complete resolution, partial resolution, or persistent cyst, with < 5 %, 5 % – 25 %, and 25 % of the original cyst volume, respectively. Results The median largest diameter of the cyst was 32 mm and the median volume was 17.1 mL. Based on cyst fluid analysis there were 71 mucinous cystic neoplasms, 16 serous cystic neoplasms, 11 intraductal papillary mucinous neoplasms, 3 pseudocysts, and 63 indeterminate cysts. Sixteen treated patients (9.8 %) had adverse events (1 severe, 4 moderate, and 11 mild). Treatment response was as follows: complete resolution in 114 (72.2 %), partial resolution in 31 (19.6 %), and persistent cysts in 13 (8.2 %). Twelve of the 13 patients with persistent cysts underwent surgery. During clinical and imaging follow-up (median 72 months, interquartile range 50 – 85 months) of the 114 patients with complete resolution, only two patients (1.7 %) showed cyst recurrence. Based on multivariate analysis, the absence of septa (odds ratio [OR] 7.12, 95 % confidence interval [CI] 2.72 – 18.67) and cyst size less than 35 mm (OR 2.39, 95 %CI 1.11 – 5.16) predicted complete resolution. Conclusion Among patients with pancreatic cysts in whom complete resolution was achieved after EUS-guided cyst ablation, 98.3 % remained in remission at 6-year follow-up. Unilocular form and small cyst size were predictive of complete resolution. This treatment approach may be an effective and durable alternative to surgery.Trial registered at ClinicalTrials.gov (NCT 00689715).

scholarly journals Predictive Factors for Pancreatic Cancer and Its Early Detection Using Special Pancreatic Ultrasonography in High-Risk Individuals

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 502
Author(s):  
Junko Fukuda ◽  
Kenji Ikezawa ◽  
Miho Nakao ◽  
Suetsumi Okagaki ◽  
Reiko Ashida ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Predictive Factors ◽  
Survival Duration ◽  
Pancreatic Cysts ◽  
Neoplastic Progression ◽  
Dismal Prognosis ◽  
Independent Risk Factors ◽  
Cyst Growth

Because pancreatic cancer has a dismal prognosis, a strategy for early diagnosis is required. This study aimed to identify predictive factors of neoplastic progression in patients at high risk for pancreatic cancer and examined the efficiency of surveillance using transabdominal special ultrasonography focusing on the pancreas (special pancreatic US). Patients with slight main pancreatic duct (MPD) dilatation (≥2.5 mm) and/or pancreatic cysts (≥5 mm) were enrolled in a prospective surveillance study with special pancreatic US in a Japanese cancer referral center. A total of 498 patients undergoing surveillance for ≥3 years were included. During the median follow-up of 5.9 years, neoplastic progression developed in 11 patients (2.2%), including 9 patients who underwent pancreatectomy. Eight patients (72.7%) were diagnosed with stage 0/I disease, with an overall survival duration of 8.8 years. Findings of both MPD dilatation and pancreatic cysts at initial surveillance, MPD growth (≥0.2 mm/year) and cyst growth (≥2 mm/year) during surveillance were identified as independent risk factors for neoplastic progression. In summary, surveillance with special pancreatic US for high-risk individuals contributed to earlier detection of neoplastic progression, leading to a favorable prognosis. During surveillance, attention should be paid to MPD growth as well as to cyst growth.

T03.01.5 AGE, OVERWEIGHT, DIABETES AND INITIAL CYST SIZE ARE ASSOCIATED WITH THE RISK OF PROGRESSION OF BD-IPMN UNDERGOING FOLLOW-UP

2020 ◽  
Vol 52 ◽  
pp. S96-S97
Author(s):  
G. Capurso ◽  
M. Traini ◽  
G. Zerboni ◽  
P. Zaccari ◽  
G. Vanella ◽  
...  
Keyword(s):  
Cyst Size ◽  
Risk Of Progression

Age, obesity, diabetes and initial cyst size are associated with the risk of progression of BD-IPMN undergoing follow-up

Pancreatology ◽  
2019 ◽  
Vol 19 ◽  
pp. S8
Author(s):  
Gabriele Capurso ◽  
Mariaemilia Traini ◽  
Giulia Zerboni ◽  
Piera Zaccari ◽  
Giuseppe Vanella ◽  
...  
Keyword(s):  
Cyst Size ◽  
Risk Of Progression

scholarly journals Long-term follow-up of neoplastic pancreatic cysts without high-risk stigmata: how often do we change treatment strategy because of malignant transformation?

2016 ◽  
Vol 51 (9) ◽  
pp. 1138-1143 ◽  
Author(s):  
Selma J. Lekkerkerker ◽  
Marc G. Besselink ◽  
Olivier R. Busch ◽  
Frederike Dijk ◽  
Marc R. Engelbrecht ◽  
...  
Keyword(s):  
High Risk ◽  
Malignant Transformation ◽  
Treatment Strategy ◽  
Pancreatic Cysts ◽  
Long Term Follow Up

scholarly journals Severe forms of neurocysticercosis: treatment with albendazole

1996 ◽  
Vol 54 (1) ◽  
pp. 82-93 ◽  
Author(s):  
Svetlana Agapejev ◽  
Maria Dorvalina da Silva ◽  
Anete K. Ueda
Keyword(s):  
Intracranial Hypertension ◽  
Ventriculoperitoneal Shunt ◽  
Severe Form ◽  
Cyst Size ◽  
Multiple Symptoms ◽  
Ivth Ventricle

Study of 22 patients with the severe form of neurocysticercosis treated with albendazole (ABZ) administered in 6 different schedules ranging from 15 to 30 mg/kg/day for 21 to 60 days. Dextrochloropheniramine and ketoprofen were the adjuvant drugs. Multiple symptoms were observed in 90.9% of patients. Intracranial hypertension was manifested in 90.9%. Hydrocephaly occurred in 86.4%. Evolution was satisfactory in 10 patients, 8 died and 4 had sequelae. Tomographic studies showed the appearance of an isolated IVth ventricle in 9 patients, after ventriculoperitoneal shunt, before ABZ treatment in 3 of them, during in 5 and after treatment in one. Median clinical follow-up duration was 10 months for the patients who died and 3-4 years for survivors. In 3 patients there was an increase in cyst size during the administration of the 15 mg/kg/day ABZ dose, which was not observed in any patient when the 30 mg/kg/day dose was used.

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