Evidence map›Paper›PMID 32819844›Full record

Observational studyPancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]2020

Risk of malignancy in small pancreatic cysts decreases over time.

D Ciprani, M Weniger, M Qadan, T Hank, N K Horick, J M Harrison, G Marchegiani, S Andrianello, P V Pandharipande, C R Ferrone and 5 more

Open access · greenAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Global Prevalence of Pancreatic Cystic Lesions in the General Population on Magnetic Resonance Imaging: A Systematic Review and Meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024
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  18. A Clinical Guide to the Management of Intraductal Papillary Mucinous Neoplasms: the Need for a More Graded Approach in Clinical Decision-making.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 3 countries.

D CipraniDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
M WenigerDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
M QadanDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
T HankDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
N K HorickBiostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
J M HarrisonDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
G MarchegianiDepartment of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
S AndrianelloDepartment of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
P V PandharipandeDepartment of Radiology, Institute for Technology Assessment, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
C R FerroneDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
K D LillemoeDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
A L WarshawDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
C BassiDepartment of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
R SalviaDepartment of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
C Fernández-Del CastilloDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: CFernandez@mgh.harvard.edu.
Harvard University · USUniversity of Verona · IT

Funding

Precision Management of Cystic Precursors to Pancreatic CancerR01CA237133 · NCI · OHIO STATE UNIVERSITY · PI PANDHARIPANDE, PARI VIJAY · 2019 to 2024
$2.2M
NCI NIH HHS R01 CA237133
6 · The paper itself

Abstract

backgroundPancreatic cysts <15 mm without worrisome features have practically no risk of malignancy at the time of diagnosis but this can change over time. Optimal duration of follow-up is a matter of debate. We evaluated predictors of malignancy and attempted to identify a time to safely discontinue surveillance.

methodsBi-centric study utilizing prospectively collected databases of patients with pancreatic cysts measuring <15 mm and without worrisome features who underwent surveillance at the Massachusetts General Hospital (1988-2017) and at the University of Verona Hospital Trust (2000-2016). The risk of malignant transformation was assessed using the Kaplan-Meier method and parametric survival models, and predictors of malignancy were evaluated using Cox regression.

results806 patients were identified. Median follow-up was 58 months (6-347). Over time, 58 (7.2%) cysts were resected and of those, 11 had high grade dysplasia (HGD) or invasive cancer. Three additional patients had unresectable cancer for a total rate of malignancy of 1.7%. Predictors of development of malignancy included an increase in size ≥2.5 mm/year (HR = 29.54, 95% CI: 9.39-92.91, P < 0.001) and the development of worrisome features (HR = 9.17, 95% CI: 2.99-28.10, P = 0.001). Comparison of parametric survival models suggested that the risk of malignancy decreased after three years of surveillance and was lower than 0.2% after five years.

conclusionsPancreatic cysts <15  mm at the time of diagnosis have a very low risk of malignant transformation. Our findings indicate the risk decreases over time. Size increase of ≥2.5 mm/year is the strongest predictor of malignancy.

Indexed as

AdolescentAdultAgedAged, 80 and overCell Transformation, NeoplasticDatabases, FactualDisease ProgressionFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedPancreatic CystPancreatic NeoplasmsPredictive Value of TestsBD-IPMNMalignancyPredictors of malignancySurveillance

Identifiers

PMID32819844
PMCPMC8168401
OpenAlexW3048300704

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.