The faith of non-surveilled pancreatic cysts: a bicentric retrospective study

Background: Incidental discovery of pancreatic cystic neoplasms (PCLs) is a common and steadily increasing occurrence. The aim of this study was to investigate a cohort of patients presenting with incidentally detected PCLs which were not included in a surveillance protocol, and to compare their risk of malignant evolution with that of systematically surveilled lesions. Materials and methods: A population of PCLs which did not receive surveillance over a period >10 years (population A) was selected at the Medical University of Vienna. A group of low risk branch duct intraductal papillary mucinous neoplasm <= 15 mm in size upon diagnosis undergoing a regular follow-up of at least 5 years at the University of Verona was selected as control (population B). The incidence of pancreatic cancer (PC), cumulative risk of PC and disease-specific survival were compared. Results: Overall, 376 patients with non-surveilled PCLs were included in study group A and compared to 299 patients in group B. This comparison resulted in similar incidence rates of PC (1.6% vs 1.7%, p = 0.938), a strong similarity in terms of disease-specific mortality rates (1.3% vs 0.3%, p = 0.171) and the 5- and 10-year cumulative risk of PC (congruent to 1% and 2%, p = 0.589) and DSS (congruent to 100% and 98%, p = 0.050). Conclusion: The price to pay for a negligence-based policy in the population of non-surveilled PCLs was reasonable, and the incidence of PC was comparable to that reported for a population of low-risk cysts enrolled to a standardized surveillance protocol. (C) 2021 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Automated summary

This study investigated incidentally detected pancreatic cystic neoplasms (PCLs) that were not included in a surveillance protocol, comparing their risk of malignant evolution with systematically surveilled lesions. The results showed that the risk of cancer development in non-surveilled PCLs was similar to that in systematically surveilled lesions.