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Am J Surg. 2007 Mar;193(3):374-8; discussion 378-9.

An aggressive surgical approach is warranted in the management of cystic pancreatic neoplasms.

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1
Department of Surgery, Division of General Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-5047, USA. Jeffrey.hardacre@uhhospitals.org

Abstract

BACKGROUND:

Cystic pancreatic neoplasms encompass a range of benign to malignant disease. Recommendations for surgical management vary.

METHODS:

Records of patients with cystic pancreatic neoplasms from January 1996 through December 2005 were retrospectively reviewed.

RESULTS:

Sixty resections were performed for 16 serous cystic neoplasms, 7 mucinous cystic neoplasms (MCNs), and 37 intraductal papillary mucinous neoplasms (IPMNs). Twenty-five percent (15/60) of neoplasms contained invasive cancer. Patients with MCN or IPMN invasive neoplasms experienced significantly diminished overall 5-year survival compared to patients with IPMN carcinoma in situ neoplasms and to patients with MCN or IPMN adenoma/borderline neoplasms (22% vs. 73% vs. 94%, P = .004).

CONCLUSIONS:

Given the poor long-term survival of patients with cystic pancreatic neoplasms containing invasive cancer and the current difficulty to preoperatively distinguish among the various types of lesions in a reliable manner, our data support an aggressive surgical approach to the management of cystic pancreatic neoplasms.

PMID:
17320538
DOI:
10.1016/j.amjsurg.2006.09.029
[Indexed for MEDLINE]
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