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Progression of pancreatic cystic lesions without any risk features is associated with initial cyst size and obesity
Author(s) -
Park Hye Won,
Lee Jong Soo,
Park Seo Young,
Kim Tae Hyup,
Lee Ji Young,
Koo Ja Eun,
Bae Suh Eun,
Choe Jaewon,
Chang HyeSook,
Park Do Hyun,
Bae Inyoung,
Park Sungwon
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14940
Subject(s) - medicine , asymptomatic , malignancy , cyst , gastroenterology , retrospective cohort study , clinical significance , body mass index , risk factor , pathology
Background and Aim The clinical significance of incidental pancreatic cystic lesions (PCLs) remains unclear in those that are not accompanied by worrisome features or high‐risk stigmata. We aimed to investigate the natural course of PCLs without any risk features and examine the clinical factors associated with their progression. Methods We conducted a retrospective cohort study of 427 patients with PCLs, which were incidentally detected by computed tomography between January 2003 and December 2012. Progression of PCLs without any risk features and the clinical factors associated with their progression were investigated. The length of time to significant growth was also evaluated. Results Ninety‐four (22.0%) of the 427 patients had asymptomatic PCLs that showed significant growth after a median surveillance period of 5.3 years; approximately 27.7% of the patients showed significant size changes in the first 5 years, while the remaining 72.3% showed significant changes after 5 years. The cumulative rate of patients with significant growth was associated with initial cyst size and high body mass index. In the growth group, additional treatments were required for 12 patients, one of whom developed malignancy. Four patients in the stable group underwent additional treatment and showed no malignant change. Conclusions One‐fifth of the asymptomatic PCLs significantly increased in size after a long‐term follow‐up period, which was associated with initial cyst size and obesity. The size of PCLs mostly increased after 5 years; although the malignancy risk of PCLs was low, it was still a concern.