Mucinous cystic neoplasms (MCNs) of the pancreas have often been confused with intraductal papillary mucinous neoplasms. We evaluated the clinicopathologic characteristics, prevalence of cancer, and prognosis of a large series of well-characterized MCNs in 2 tertiary centers.Analysis of 163 patients with resected MCNs, defined by the presence of ovarian stroma and lack of communication with the main pancreatic duct.MCNs were seen mostly in women (95\%) and in the distal pancreas (97\%); 25\% were incidentally discovered. Symptomatic patients typically had mild abdominal pain, but 9\% presented with acute pancreatitis. One hundred eighteen patients (72\%) had adenoma, 17 (10.5\%) borderline tumors, 9 (5.5\%) in situ carcinoma, and 19 (12\%) invasive carcinoma. Patients with invasive carcinoma were significantly older than those with noninvasive neoplasms (55 vs. 44 years, P = 0.01). Findings associated with malignancy were presence of nodules (P = 0.0001) and diameter > or =60 mm (P = 0.0001). All neoplasms with cancer were either > or =40 mm in size or had nodules. There was no operative mortality and postoperative morbidity was 49\%. Median follow-up was 57 months (range, 4-233); only patients with invasive carcinoma had recurrence. The 5-year disease-specific survival for noninvasive MCNs was 100\%, and for those with invasive cancer, 57\%.This series, the largest with MCNs defined by ovarian stroma, shows a prevalence of cancer of only 17.5\%. Patients with invasive carcinoma are older, suggesting progression from adenoma to carcinoma. Although resection should be considered for all cases, in low-risk MCNs (< or =4 cm/no nodules), nonradical resections are appropriate.

Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients.

CRIPPA, Stefano;SALVIA, Roberto;BASSI, Claudio;FALCONI, Massimo;ZAMBONI, Giuseppe;Capelli, Paola;PEDERZOLI, Paolo;
2008-01-01

Abstract

Mucinous cystic neoplasms (MCNs) of the pancreas have often been confused with intraductal papillary mucinous neoplasms. We evaluated the clinicopathologic characteristics, prevalence of cancer, and prognosis of a large series of well-characterized MCNs in 2 tertiary centers.Analysis of 163 patients with resected MCNs, defined by the presence of ovarian stroma and lack of communication with the main pancreatic duct.MCNs were seen mostly in women (95\%) and in the distal pancreas (97\%); 25\% were incidentally discovered. Symptomatic patients typically had mild abdominal pain, but 9\% presented with acute pancreatitis. One hundred eighteen patients (72\%) had adenoma, 17 (10.5\%) borderline tumors, 9 (5.5\%) in situ carcinoma, and 19 (12\%) invasive carcinoma. Patients with invasive carcinoma were significantly older than those with noninvasive neoplasms (55 vs. 44 years, P = 0.01). Findings associated with malignancy were presence of nodules (P = 0.0001) and diameter > or =60 mm (P = 0.0001). All neoplasms with cancer were either > or =40 mm in size or had nodules. There was no operative mortality and postoperative morbidity was 49\%. Median follow-up was 57 months (range, 4-233); only patients with invasive carcinoma had recurrence. The 5-year disease-specific survival for noninvasive MCNs was 100\%, and for those with invasive cancer, 57\%.This series, the largest with MCNs defined by ovarian stroma, shows a prevalence of cancer of only 17.5\%. Patients with invasive carcinoma are older, suggesting progression from adenoma to carcinoma. Although resection should be considered for all cases, in low-risk MCNs (< or =4 cm/no nodules), nonradical resections are appropriate.
2008
Adenocarcinoma; Mucinous; Adenoma; Adolescent; Adult; Aged; 80 and over; Female; Humans; Male; Middle Aged; Pancreatic Neoplasms; Survival Analysis
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/353255
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