851 resected cystic tumors of the pancreas: A 33-year experience at the Massachusetts General Hospital
Open accessAbstract
Background The objective of this study was to identify trends in the diagnosis and treatment of cystic neoplasms of the pancreas using a retrospective review of patients from a surgical database at an academic referral center during a 33-year period. Methods Patient characteristics, including demographics, pathology, and survival, were analyzed over 5 time periods between 1978 and 2011. Results A total of 851 consecutive patients underwent resection for a cystic neoplasm of the pancreas during a 33-year period. Sixty-five percent of patients were female, and mean age was 60 years. The most common pathologic diagnoses were intraductal papillary mucinous neoplasm (38%), mucinous cystic neoplasm (23%), serous cystadenoma (16%), and cystic neuroendocrine neoplasm (7%). There was a stepwise increase in the number of resections across time periods (67 between 1978 and 1989; 376 between 2005 and 2011), with a parallel increase in the proportion of incidentally discovered lesions (22% to 50%). Diagnosis of intraductal papillary mucinous neoplasm was very uncommon in the first 2 time periods (before the first recognition of intraductal papillary mucinous neoplasm as a distinct entity) but predominated in the last 2 (41% and 49%), and cystic neuroendocrine neoplasms, which constituted 3% of the cystic neoplasms in the first time-period, now comprise more than 8% of pancreatic cystic neoplasms. The proportion of malignant neoplasms decreased over time (41% between 1978 and 1989; 12% between 2005 and 2011), reflecting probably the earlier diagnosis and treatment of premalignant neoplasms. Although operative mortality was minimal (4/849, 0.5%), the postoperative complication rate was 38%. Overall 5-year survival for all mucinous lesions was 87%. Conclusion Cystic neoplasms of the pancreas are being diagnosed and treated with increasing frequency. At present, most are incidentally discovered intraductal papillary mucinous neoplasms.
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Approximately 42-63% of resected IPMNs were found to have only low-grade dysplasia.
“While the goal of surgery is to resect lesions with advanced neoplasia (high-grade dysplasia and/or adenocarcinoma), approximately 42–63% of resected IPMNs were found to have only low-grade dysplasia [12,13,14,15,16,17].”
From Artificial Intelligence in the Diagnosis and Treatment of Pancreatic Cystic Lesions and Adenocarcinoma (2023) · cites this paper as [12]
25% of patients who have a presumed mucinous cystic lesion removed are ultimately found to have a cyst with no malignant potential.
“25% of patients who have a presumed mucinous cystic lesion removed are ultimately found to have a cyst with no malignant potential,39”
From Early detection of pancreatic cancer (2020) · cites this paper as [39]
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Research works printed but not linked: 24
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- Authors
- Valsangkar, N. P., Morales-Oyarvide, V., Thayer, S. P., Ferrone, C. R., Wargo, J. A., Warshaw, A. L., & Fernández-del Castillo, C.
- Affiliations
- Harvard University (US)
- Venue
- Surgery
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 152
- Issue
- 3
- Pages
- S4-S12
- ISSN
- 0039-6060 (ISSN-L)
- PMC
- PMC3806101
- OpenAlex
- W2114997989
- Cited by
- 418
- References
- 0
- Citations by year
- 2026: 16 · 2025: 15 · 2024: 22 · 2023: 29 · 2022: 34 · 2021: 40 · 2020: 32 · 2019: 33 · 2018: 43 · 2017: 35 · 2016: 34 · 2015: 34 · 2014: 31 · 2013: 16 · 2012: 2
- FWCI
- 13.14
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P01CA117969)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Keywords
- pancreatic cystic neoplasms, pancreatic resection, intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, serous cystadenoma, incidental finding, postoperative mortality, postoperative complications, five-year survival, temporal trends in diagnosis
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Pancreatectomy, Pancreatic Neoplasms, Postoperative Complications, Survival Rate, Pancreaticoduodenectomy, Cystadenoma, Mucinous, Cystadenoma, Serous, Neuroendocrine Tumors
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