851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital.
851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital.
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DOI：
10.1016/j.surg.2012.05.033
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发表时间：
2012-09
期刊：
影响因子：
3.8
通讯作者：
Fernandez-del Castillo, Carlos
中科院分区：
文献类型：
--
作者：
Valsangkar, Nakul P.;Morales-Oyarvide, Vicente;Thayer, Sarah P.;Ferrone, Cristina R.;Wargo, Jennifer A.;Warshaw, Andrew L.;Fernandez-del Castillo, Carlos
本研究的目的是通过对学术转诊中心外科数据库中 33 年来的患者进行回顾性审查，确定胰腺囊性肿瘤的诊断和治疗趋势。对 1978 年至 2011 年间 5 个时期的患者特征（包括人口统计学、病理学和生存率）进行了分析。在 33 年期间，共有 851 名连续患者接受了胰腺囊性肿瘤切除术。 65% 的患者为女性，平均年龄为 60 岁。最常见的病理诊断是导管内乳头状粘液性肿瘤（38%）、粘液性囊性肿瘤（23%）、浆液性囊腺瘤（16%）和囊性神经内分泌肿瘤（7%）。不同时期的切除数量逐步增加（1978年至1989年间为67例；2005年至2011年间为376例），同时偶然发现病变的比例也相应增加（22%至50%）。导管内乳头状粘液性肿瘤的诊断在前两个时期（在首次认识到导管内乳头状粘液性肿瘤作为一个独特实体之前）非常罕见，但在后两个时期占主导地位（41％和49％），而囊性神经内分泌肿瘤在第一个时期占囊性肿瘤的3％，现在占胰腺囊性肿瘤的8％以上。恶性肿瘤的比例随着时间的推移而下降（1978年至1989年为41%；2005年至2011年为12%），这可能反映了癌前肿瘤的早期诊断和治疗。尽管手术死亡率极低（4/849，0.5%），但术后并发症发生率为38%。所有粘液性病变的总体 5 年生存率为 87%。胰腺囊性肿瘤的诊断和治疗频率不断增加。目前，大多数是偶然发现的导管内乳头状粘液性肿瘤。 （外科手术 2012；152：S4–12。）
The objective of this study was to identify trends in the diagnosis and treatment of cystic neoplasms of the pancreas using a retrospective review of patients from a surgical database at an academic referral center during a 33-year period. Patient characteristics, including demographics, pathology, and survival, were analyzed over 5 time periods between 1978 and 2011. A total of 851 consecutive patients underwent resection for a cystic neoplasm of the pancreas during a 33-year period. Sixty-five percent of patients were female, and mean age was 60 years. The most common pathologic diagnoses were intraductal papillary mucinous neoplasm (38%), mucinous cystic neoplasm (23%), serous cystadenoma (16%), and cystic neuroendocrine neoplasm (7%). There was a stepwise increase in the number of resections across time periods (67 between 1978 and 1989; 376 between 2005 and 2011), with a parallel increase in the proportion of incidentally discovered lesions (22% to 50%). Diagnosis of intraductal papillary mucinous neoplasm was very uncommon in the first 2 time periods (before the first recognition of intraductal papillary mucinous neoplasm as a distinct entity) but predominated in the last 2 (41% and 49%), and cystic neuroendocrine neoplasms, which constituted 3% of the cystic neoplasms in the first time-period, now comprise more than 8% of pancreatic cystic neoplasms. The proportion of malignant neoplasms decreased over time (41% between 1978 and 1989; 12% between 2005 and 2011), reflecting probably the earlier diagnosis and treatment of premalignant neoplasms. Although operative mortality was minimal (4/849, 0.5%), the postoperative complication rate was 38%. Overall 5-year survival for all mucinous lesions was 87%. Cystic neoplasms of the pancreas are being diagnosed and treated with increasing frequency. At present, most are incidentally discovered intraductal papillary mucinous neoplasms. (Surgery 2012;152:S4–12.)
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DOI：
10.2214/ajr.07.3340
发表时间：
2008-09
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Laffan TA;Horton KM;Klein AP;Berlanstein B;Siegelman SS;Kawamoto S;Johnson PT;Fishman EK;Hruban RH
通讯作者：
Hruban RH
影响因子：
--
作者：
Balcom, JH;Rattner, DW;Fernandez-del Castillo, C
通讯作者：
Fernandez-del Castillo, C
影响因子：
9
作者：
Ferrone, Cristina R.;Konstantinidis, Ioannis T.;Warshaw, Andrew L.
通讯作者：
Warshaw, Andrew L.
影响因子：
3.8
作者：
Walsh, R. Matthew;Vogt, David P.;Brown, Nancy
通讯作者：
Brown, Nancy
影响因子：
1.9
作者：
Megibow, Alec J.;Baker, Mark E.;Taylor, Andrew
通讯作者：
Taylor, Andrew