Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort

Valerie Gausman, Pujan Kandel, Priscilla A. Van Riet, Maria Moris, Maia Kayal, Catherine Do, John M. Poneros, Amrita Sethi, Frank G. Gress, Beth A. Schrope, Lyndon Luk, Elizabeth Hecht, Manol Jovani, Marco J. Bruno, Djuna L. Cahen, Michael B. Wallace, Tamas A. Gonda

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). Methods This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included. We evaluated the relationship of baseline demographics and cyst features to disease progression (size increase, development of worrisome features, or high-grade dysplasia/cancer). Results After a median of 44 months follow-up, 269 (48%) patients experienced cyst size increase, 68 (12%) developed worrisome features, and 11 (2%) developed high-grade dysplasia/cancer. In multivariable Cox-regression analysis, no baseline characteristics were associated with size increase. An initial cyst size of 2 cm or greater, multifocality, history of prostate cancer, and smoking were the strongest predictors of development of new worrisome features. Univariable analysis found male sex, diabetes, and recent weight loss associated with development of high-grade dysplasia/cancer. Conclusions Our study demonstrates that low-risk suspected IPMNs carry a small but clinically relevant risk of disease progression and provides data on baseline characteristics that may help in risk stratification.

Original languageEnglish (US)
Pages (from-to)471-476
Number of pages6
JournalPancreas
Volume47
Issue number4
DOIs
StatePublished - Apr 1 2018

Fingerprint

Disease Progression
Cysts
Neoplasms
Pancreatic Cyst
Weight Loss
Prostatic Neoplasms
Cohort Studies
Retrospective Studies
Smoking
Regression Analysis
Demography
Databases

Keywords

  • Disease progression
  • Low risk
  • Pancreatic cysts
  • Risk factors
  • Surveillance

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Gausman, V., Kandel, P., Van Riet, P. A., Moris, M., Kayal, M., Do, C., ... Gonda, T. A. (2018). Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort. Pancreas, 47(4), 471-476. https://doi.org/10.1097/MPA.0000000000001027

Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort. / Gausman, Valerie; Kandel, Pujan; Van Riet, Priscilla A.; Moris, Maria; Kayal, Maia; Do, Catherine; Poneros, John M.; Sethi, Amrita; Gress, Frank G.; Schrope, Beth A.; Luk, Lyndon; Hecht, Elizabeth; Jovani, Manol; Bruno, Marco J.; Cahen, Djuna L.; Wallace, Michael B.; Gonda, Tamas A.

In: Pancreas, Vol. 47, No. 4, 01.04.2018, p. 471-476.

Research output: Contribution to journalArticle

Gausman, V, Kandel, P, Van Riet, PA, Moris, M, Kayal, M, Do, C, Poneros, JM, Sethi, A, Gress, FG, Schrope, BA, Luk, L, Hecht, E, Jovani, M, Bruno, MJ, Cahen, DL, Wallace, MB & Gonda, TA 2018, 'Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort', Pancreas, vol. 47, no. 4, pp. 471-476. https://doi.org/10.1097/MPA.0000000000001027
Gausman, Valerie ; Kandel, Pujan ; Van Riet, Priscilla A. ; Moris, Maria ; Kayal, Maia ; Do, Catherine ; Poneros, John M. ; Sethi, Amrita ; Gress, Frank G. ; Schrope, Beth A. ; Luk, Lyndon ; Hecht, Elizabeth ; Jovani, Manol ; Bruno, Marco J. ; Cahen, Djuna L. ; Wallace, Michael B. ; Gonda, Tamas A. / Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort. In: Pancreas. 2018 ; Vol. 47, No. 4. pp. 471-476.
@article{76e15bf7821541f79cc9d46efbdc33d4,
title = "Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort",
abstract = "Objectives Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). Methods This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included. We evaluated the relationship of baseline demographics and cyst features to disease progression (size increase, development of worrisome features, or high-grade dysplasia/cancer). Results After a median of 44 months follow-up, 269 (48{\%}) patients experienced cyst size increase, 68 (12{\%}) developed worrisome features, and 11 (2{\%}) developed high-grade dysplasia/cancer. In multivariable Cox-regression analysis, no baseline characteristics were associated with size increase. An initial cyst size of 2 cm or greater, multifocality, history of prostate cancer, and smoking were the strongest predictors of development of new worrisome features. Univariable analysis found male sex, diabetes, and recent weight loss associated with development of high-grade dysplasia/cancer. Conclusions Our study demonstrates that low-risk suspected IPMNs carry a small but clinically relevant risk of disease progression and provides data on baseline characteristics that may help in risk stratification.",
keywords = "Disease progression, Low risk, Pancreatic cysts, Risk factors, Surveillance",
author = "Valerie Gausman and Pujan Kandel and {Van Riet}, {Priscilla A.} and Maria Moris and Maia Kayal and Catherine Do and Poneros, {John M.} and Amrita Sethi and Gress, {Frank G.} and Schrope, {Beth A.} and Lyndon Luk and Elizabeth Hecht and Manol Jovani and Bruno, {Marco J.} and Cahen, {Djuna L.} and Wallace, {Michael B.} and Gonda, {Tamas A.}",
year = "2018",
month = "4",
day = "1",
doi = "10.1097/MPA.0000000000001027",
language = "English (US)",
volume = "47",
pages = "471--476",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Predictors of progression among low-risk intraductal papillary mucinous neoplasms in a multicenter surveillance cohort

AU - Gausman, Valerie

AU - Kandel, Pujan

AU - Van Riet, Priscilla A.

AU - Moris, Maria

AU - Kayal, Maia

AU - Do, Catherine

AU - Poneros, John M.

AU - Sethi, Amrita

AU - Gress, Frank G.

AU - Schrope, Beth A.

AU - Luk, Lyndon

AU - Hecht, Elizabeth

AU - Jovani, Manol

AU - Bruno, Marco J.

AU - Cahen, Djuna L.

AU - Wallace, Michael B.

AU - Gonda, Tamas A.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Objectives Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). Methods This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included. We evaluated the relationship of baseline demographics and cyst features to disease progression (size increase, development of worrisome features, or high-grade dysplasia/cancer). Results After a median of 44 months follow-up, 269 (48%) patients experienced cyst size increase, 68 (12%) developed worrisome features, and 11 (2%) developed high-grade dysplasia/cancer. In multivariable Cox-regression analysis, no baseline characteristics were associated with size increase. An initial cyst size of 2 cm or greater, multifocality, history of prostate cancer, and smoking were the strongest predictors of development of new worrisome features. Univariable analysis found male sex, diabetes, and recent weight loss associated with development of high-grade dysplasia/cancer. Conclusions Our study demonstrates that low-risk suspected IPMNs carry a small but clinically relevant risk of disease progression and provides data on baseline characteristics that may help in risk stratification.

AB - Objectives Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). Methods This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included. We evaluated the relationship of baseline demographics and cyst features to disease progression (size increase, development of worrisome features, or high-grade dysplasia/cancer). Results After a median of 44 months follow-up, 269 (48%) patients experienced cyst size increase, 68 (12%) developed worrisome features, and 11 (2%) developed high-grade dysplasia/cancer. In multivariable Cox-regression analysis, no baseline characteristics were associated with size increase. An initial cyst size of 2 cm or greater, multifocality, history of prostate cancer, and smoking were the strongest predictors of development of new worrisome features. Univariable analysis found male sex, diabetes, and recent weight loss associated with development of high-grade dysplasia/cancer. Conclusions Our study demonstrates that low-risk suspected IPMNs carry a small but clinically relevant risk of disease progression and provides data on baseline characteristics that may help in risk stratification.

KW - Disease progression

KW - Low risk

KW - Pancreatic cysts

KW - Risk factors

KW - Surveillance

UR - http://www.scopus.com/inward/record.url?scp=85044247145&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044247145&partnerID=8YFLogxK

U2 - 10.1097/MPA.0000000000001027

DO - 10.1097/MPA.0000000000001027

M3 - Article

VL - 47

SP - 471

EP - 476

JO - Pancreas

JF - Pancreas

SN - 0885-3177

IS - 4

ER -