Optimal Follow-up of Incidental Pancreatic Cystic Lesions without Worrisome Features: Clinical Outcome after Long-term Follow-up

• Published in: Gut and liver 2024, 18(2), , pp.328-337
• Main Authors: Ahn, Dong-Won, Lee, Sang Hyub, Choi, Jin Ho, Cho, In Rae, Jang, Dong Kee, Paik, Woo Hyun, Jeong, Ji Bong, Ryu, Ji Kon, Kim, Yong-Tae
• Format: Article
• Language: English
• Subjects: Disease Progression; Follow-Up Studies; Humans; Original; Pancreas - diagnostic imaging; Pancreas - pathology; Pancreas - surgery; Pancreatic Cyst - diagnostic imaging; Pancreatic Cyst - pathology; Pancreatic Cyst - surgery; pancreatic cyst; pancreatic neoplasms; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - surgery; Retrospective Studies; 내과학
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl230017

: The optimal duration and interval of follow-up for cystic lesions of the pancreas (CLPs) is not well established. This study was performed to investigate the optimal duration and interval of follow-up for CLPs in clinical practice. : Patients with CLPs without worrisome features or high-risk stigmata underwent follow-up with computed tomography at 6, 12, 18, and 24 months and then every 12 months thereafter. A retrospective analysis of prospectively collected data was performed. : A total of 227 patients with CLPs detected from 2000 to 2008 (mean initial diameter, 1.3±0.6 cm) underwent follow-up for a median of 120 months. Twenty-two patients (9.7%) underwent surgery after a median of 47.5 months. Malignancies developed in four patients (1.8%), one within 5 years and three within 10 years. One hundred and fourteen patients (50.2%) were followed up for more than 10 years. No malignancy developed after 10 years of follow-up. During surveillance, 37 patients (16.3%) experienced progression to surgical indication. In patients with CLPs less than 2 cm in diameter, development of surgical indications did not occur within 24 months of follow-up. : CLPs should be continuously monitored after 5 years because of the persistent potential for malignant transformation of CLPs. An interval of 24 months for initial follow-up might be enough for CLPs with initial size of less than 2 cm in clinical practice.