ArticleJournal of the American College of Surgeons2025
Natural History of Pancreatic Cyst with Diameter as Solitary Risk Factor.
Article in Journal of the American College of Surgeons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMultiple pancreatic cyst surveillance guidelines include cyst diameter 3 cm or greater as a worrisome feature prompting surgical referral. STUDY
designThis was a single-center retrospective review of patients with pancreatic cysts 3 cm or greater at diagnosis and no other worrisome features. Cyst progression was defined as the development of additional worrisome features, pancreatic cancer diagnosis, or pancreatectomy. Pseudocysts and biopsy-proven malignancies or non-intraductal papillary mucinous neoplasm cysts at initial consultation were excluded.
resultsBetween 2010 and 2019, 89 patients met eligibility criteria with median age of 70.9 (21 to 91) years, cyst size of 3.5 (3.10 to 9.7) cm, and follow-up of 85.7 (30.8 to 139.3) months. Cyst progression or resection occurred in 13 during follow-up There were no cases of pancreatic cancer or high-grade dysplasia on postoperative pathology. Twelve patients (13%) died without evidence of progression. Cumulative incidence of progression from surveillance initiation was 3.4% (95% CI 0.9% to 8.8%) at 3 months, 5.6% (95% CI 2.1% to 11.9%) at 9 months, 9.0% (95% CI 4.2% to 16.2%) at 15 months, 11.2% (95% CI 5.7% to 18.8%) at 21 months, and 13.7% (95% CI 7.5% to 21.8%) at 57 months.
conclusionsPancreatic cysts with a diameter 3 cm or greater as the sole worrisome feature can be safely monitored with low rates of progression during surveillance, and no incidence of cancer or high-grade dysplasia in our cohort.
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