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Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review [version 2; peer review: 2 approved]

Keane, MG; Dadds, HR; El Sayed, G; Luong, TV; Davidson, BR; Fusai, GK; Thorburn, D; (2020) Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review [version 2; peer review: 2 approved]. AMRC Open Research , 1 , Article 4. 10.12688/amrcopenres.12860.2. Green open access

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Abstract

BACKGROUND: Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance. METHODS: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting. RESULTS: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting. CONCLUSION: The sensitivity of standard diagnostic tests leading to immediate surgery for high-risk PCL (malignant or mucinous) was 92% but with a specificity of just 5%. Surveillance of PCL without high-risk features within a multidisciplinary meeting was associated with a low incidence of cancer development, supporting the use of worrisome clinical and radiological features in the initial stratification of PCL.

Type: Article
Title: Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review [version 2; peer review: 2 approved]
Open access status: An open access version is available from UCL Discovery
DOI: 10.12688/amrcopenres.12860.2
Publisher version: https://doi.org/10.12688/amrcopenres.12860.2
Language: English
Additional information: © 2020 Keane MG et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Pancreatic cystic lesion, IPMN, MCN, SCN, SPN, Pancreatic cancer, PNET
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10090724
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