Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report
Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this stu...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2008-02, Vol.12 (2), p.234-242 |
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| creator | Lee, C. J. Scheiman, J. Anderson, M. A. Hines, O. J. Reber, H. A. Farrell, J. Kochman, M. L. Foley, P. J. Drebin, J. Oh, Y. S. Ginsberg, G. Ahmad, N. Merchant, N. B. Isbell, J. Parikh, A. A. Stokes, J. B. Bauer, T. Adams, R. B. Simeone, D. M. |
| description | Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this study was to determine the prevalence of malignancy in this group of patients using pancreatic resection databases from five high-volume pancreatic centers to assess the appropriateness of these guidelines. All pancreatic resections performed for cystic neoplasms ≤3 cm in size were evaluated over the time period of 1998–2006. One hundred sixty-six cases were identified, and the clinical, radiographic, and pathological data were reviewed. The correlation with age, gender, and symptoms (abdominal pain, nausea and vomiting, jaundice, presence of pancreatitis, unexplained weight loss, and anorexia), radiographic features suggestive of malignancy by either computed tomography, magnetic resonance imaging, or endoscopic ultrasound (presence of solid component, lymphadenopathy, or dilated main pancreatic duct or common bile duct), and the presence of malignancy was assessed using univariate and multivariate analysis. Among the 166 pancreatic resections for cystic pancreatic tumors ≤3 cm, 135 cases were benign [38 serous cystadenomas, 35 mucinous cystic neoplasms, 60 intraductal papillary mucinous neoplasms (IPMN), 1 cystic papillary tumor, and 1 cystic islet cell tumor], whereas 31 cases were malignant (14 mucinous cystic adenocarcinomas and 13 invasive carcinomas and 4 in situ carcinomas arising in the setting of IPMN). A greater incidence of cystic neoplasms was seen in female patients (99/166, 60%). Gender was a predictor of malignant pathology, with male patients having a higher incidence of malignancy (19/67, 28%) compared to female patients (12/99, 12%;
p
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| doi_str_mv | 10.1007/s11605-007-0381-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70247295</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70247295</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-a3db93f51b0c86fbfb4df01604a35536f7f797e14075497efc3932357b2773b53</originalsourceid><addsrcrecordid>eNp1kc9qFTEYxYMotlYfwI0EBHfR_JlMZtzI5eKfQktLW8FdyOQmNXVmcpsvI4xv4Bu4dOGT-Cg-iRnuBUVwkxzI7zsnyUHoMaPPGaXqBTBWU0mKJFQ0jMx30CFrlCBVzeu7RdOWES7lhwP0AOCGUqYoa-6jA9bQiqqqPUTfLgJ8wtHjU9OH69GMdsZhxBcOnM1ug9cz5GDx1TTEBAuXPzp8XrDkDOBfX3-In9_tsIxchi_uJT4GHDK-NN7hHPFZBy59dngF87DNcTCL13lZ3ZjhFV7h06nPgYSxhOQphziavmRvY8oP0T1venCP9vsRev_m9dX6HTk5e3u8Xp0QKxTNxIhN1wovWUdtU_vOd9XG0_ItlRFSitorr1rlWHmurIrwVrSCC6k6rpTopDhCz3a-2xRvJwdZDwGs63szujiBVpRXircL-PQf8CZOqVwYNGOMc1Er2RSK7SibIkByXm9TGEyaNaN6KU3vStOLXErTc5l5sneeusFt_kzsWyoA3wFQjsZrl_6K_q_rb5nHpDk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1112236758</pqid></control><display><type>article</type><title>Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Lee, C. J. ; Scheiman, J. ; Anderson, M. A. ; Hines, O. J. ; Reber, H. A. ; Farrell, J. ; Kochman, M. L. ; Foley, P. J. ; Drebin, J. ; Oh, Y. S. ; Ginsberg, G. ; Ahmad, N. ; Merchant, N. B. ; Isbell, J. ; Parikh, A. A. ; Stokes, J. B. ; Bauer, T. ; Adams, R. B. ; Simeone, D. M.</creator><creatorcontrib>Lee, C. J. ; Scheiman, J. ; Anderson, M. A. ; Hines, O. J. ; Reber, H. A. ; Farrell, J. ; Kochman, M. L. ; Foley, P. J. ; Drebin, J. ; Oh, Y. S. ; Ginsberg, G. ; Ahmad, N. ; Merchant, N. B. ; Isbell, J. ; Parikh, A. A. ; Stokes, J. B. ; Bauer, T. ; Adams, R. B. ; Simeone, D. M.</creatorcontrib><description><![CDATA[Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this study was to determine the prevalence of malignancy in this group of patients using pancreatic resection databases from five high-volume pancreatic centers to assess the appropriateness of these guidelines. All pancreatic resections performed for cystic neoplasms ≤3 cm in size were evaluated over the time period of 1998–2006. One hundred sixty-six cases were identified, and the clinical, radiographic, and pathological data were reviewed. The correlation with age, gender, and symptoms (abdominal pain, nausea and vomiting, jaundice, presence of pancreatitis, unexplained weight loss, and anorexia), radiographic features suggestive of malignancy by either computed tomography, magnetic resonance imaging, or endoscopic ultrasound (presence of solid component, lymphadenopathy, or dilated main pancreatic duct or common bile duct), and the presence of malignancy was assessed using univariate and multivariate analysis. Among the 166 pancreatic resections for cystic pancreatic tumors ≤3 cm, 135 cases were benign [38 serous cystadenomas, 35 mucinous cystic neoplasms, 60 intraductal papillary mucinous neoplasms (IPMN), 1 cystic papillary tumor, and 1 cystic islet cell tumor], whereas 31 cases were malignant (14 mucinous cystic adenocarcinomas and 13 invasive carcinomas and 4 in situ carcinomas arising in the setting of IPMN). A greater incidence of cystic neoplasms was seen in female patients (99/166, 60%). Gender was a predictor of malignant pathology, with male patients having a higher incidence of malignancy (19/67, 28%) compared to female patients (12/99, 12%;
p
< 0.02). Older age was associated with malignancy (mean age 67 years in patients with malignant disease vs 62 years in patients with benign lesions (
p
< 0.05). A majority of the patients with malignancy were symptomatic (28/31, 90%). Symptoms that correlated with malignancy included jaundice (
p
< 0.001), weight loss (
p
< 0.003), and anorexia (
p
< 0.05). Radiographic features that correlated with malignancy were presence of a solid component (
p
< 0.0001), main pancreatic duct dilation (
p
= 0.002), common bile duct dilation (
p
< 0.001), and lymphadenopathy (
p
< 0.002). Twenty-seven of 31(87%) patients with malignant lesions had at least one radiographic feature concerning for malignancy. Forty-five patients (27%) were identified as having asymptomatic cystic neoplasms. All but three (6.6%) of the patients in this group had benign disease. Of the patients that had no symptoms and no radiographic features, 1 out of 30 (3.3%) had malignancy (carcinoma in situ arising in a side branch IPMN). Malignancy in cystic neoplasms ≤3 cm in size was associated with older age, male gender, presence of symptoms (jaundice, weight loss, and anorexia), and presence of concerning radiographic features (solid component, main pancreatic duct dilation, common bile duct dilation, and lymphadenopathy). Among asymptomatic patients that displayed no discernable radiographic features suggestive of malignancy who underwent resection, the incidence of occult malignancy was 3.3%. This study suggests that a group of patients with small cystic pancreatic neoplasms who have low risk of malignancy can be identified, and selective resection of these lesions may be appropriate.]]></description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-007-0381-y</identifier><identifier>PMID: 18040749</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Age ; Aged ; Carcinoma, Pancreatic Ductal - pathology ; Carcinoma, Pancreatic Ductal - surgery ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Cystadenoma, Serous - pathology ; Cystadenoma, Serous - surgery ; Female ; Gastroenterology ; Gender ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Pancreas ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Risk Factors ; SSAT plenery presentation ; Surgery ; Tumors</subject><ispartof>Journal of gastrointestinal surgery, 2008-02, Vol.12 (2), p.234-242</ispartof><rights>The Society for Surgery of the Alimentary Tract 2007</rights><rights>The Society for Surgery of the Alimentary Tract 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-a3db93f51b0c86fbfb4df01604a35536f7f797e14075497efc3932357b2773b53</citedby><cites>FETCH-LOGICAL-c370t-a3db93f51b0c86fbfb4df01604a35536f7f797e14075497efc3932357b2773b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-007-0381-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-007-0381-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18040749$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, C. J.</creatorcontrib><creatorcontrib>Scheiman, J.</creatorcontrib><creatorcontrib>Anderson, M. A.</creatorcontrib><creatorcontrib>Hines, O. J.</creatorcontrib><creatorcontrib>Reber, H. A.</creatorcontrib><creatorcontrib>Farrell, J.</creatorcontrib><creatorcontrib>Kochman, M. L.</creatorcontrib><creatorcontrib>Foley, P. J.</creatorcontrib><creatorcontrib>Drebin, J.</creatorcontrib><creatorcontrib>Oh, Y. S.</creatorcontrib><creatorcontrib>Ginsberg, G.</creatorcontrib><creatorcontrib>Ahmad, N.</creatorcontrib><creatorcontrib>Merchant, N. B.</creatorcontrib><creatorcontrib>Isbell, J.</creatorcontrib><creatorcontrib>Parikh, A. A.</creatorcontrib><creatorcontrib>Stokes, J. B.</creatorcontrib><creatorcontrib>Bauer, T.</creatorcontrib><creatorcontrib>Adams, R. B.</creatorcontrib><creatorcontrib>Simeone, D. M.</creatorcontrib><title>Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description><![CDATA[Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this study was to determine the prevalence of malignancy in this group of patients using pancreatic resection databases from five high-volume pancreatic centers to assess the appropriateness of these guidelines. All pancreatic resections performed for cystic neoplasms ≤3 cm in size were evaluated over the time period of 1998–2006. One hundred sixty-six cases were identified, and the clinical, radiographic, and pathological data were reviewed. The correlation with age, gender, and symptoms (abdominal pain, nausea and vomiting, jaundice, presence of pancreatitis, unexplained weight loss, and anorexia), radiographic features suggestive of malignancy by either computed tomography, magnetic resonance imaging, or endoscopic ultrasound (presence of solid component, lymphadenopathy, or dilated main pancreatic duct or common bile duct), and the presence of malignancy was assessed using univariate and multivariate analysis. Among the 166 pancreatic resections for cystic pancreatic tumors ≤3 cm, 135 cases were benign [38 serous cystadenomas, 35 mucinous cystic neoplasms, 60 intraductal papillary mucinous neoplasms (IPMN), 1 cystic papillary tumor, and 1 cystic islet cell tumor], whereas 31 cases were malignant (14 mucinous cystic adenocarcinomas and 13 invasive carcinomas and 4 in situ carcinomas arising in the setting of IPMN). A greater incidence of cystic neoplasms was seen in female patients (99/166, 60%). Gender was a predictor of malignant pathology, with male patients having a higher incidence of malignancy (19/67, 28%) compared to female patients (12/99, 12%;
p
< 0.02). Older age was associated with malignancy (mean age 67 years in patients with malignant disease vs 62 years in patients with benign lesions (
p
< 0.05). A majority of the patients with malignancy were symptomatic (28/31, 90%). Symptoms that correlated with malignancy included jaundice (
p
< 0.001), weight loss (
p
< 0.003), and anorexia (
p
< 0.05). Radiographic features that correlated with malignancy were presence of a solid component (
p
< 0.0001), main pancreatic duct dilation (
p
= 0.002), common bile duct dilation (
p
< 0.001), and lymphadenopathy (
p
< 0.002). Twenty-seven of 31(87%) patients with malignant lesions had at least one radiographic feature concerning for malignancy. Forty-five patients (27%) were identified as having asymptomatic cystic neoplasms. All but three (6.6%) of the patients in this group had benign disease. Of the patients that had no symptoms and no radiographic features, 1 out of 30 (3.3%) had malignancy (carcinoma in situ arising in a side branch IPMN). Malignancy in cystic neoplasms ≤3 cm in size was associated with older age, male gender, presence of symptoms (jaundice, weight loss, and anorexia), and presence of concerning radiographic features (solid component, main pancreatic duct dilation, common bile duct dilation, and lymphadenopathy). Among asymptomatic patients that displayed no discernable radiographic features suggestive of malignancy who underwent resection, the incidence of occult malignancy was 3.3%. This study suggests that a group of patients with small cystic pancreatic neoplasms who have low risk of malignancy can be identified, and selective resection of these lesions may be appropriate.]]></description><subject>Age</subject><subject>Aged</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Cystadenoma, Serous - pathology</subject><subject>Cystadenoma, Serous - surgery</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gender</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Pancreas</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreaticoduodenectomy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>SSAT plenery presentation</subject><subject>Surgery</subject><subject>Tumors</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc9qFTEYxYMotlYfwI0EBHfR_JlMZtzI5eKfQktLW8FdyOQmNXVmcpsvI4xv4Bu4dOGT-Cg-iRnuBUVwkxzI7zsnyUHoMaPPGaXqBTBWU0mKJFQ0jMx30CFrlCBVzeu7RdOWES7lhwP0AOCGUqYoa-6jA9bQiqqqPUTfLgJ8wtHjU9OH69GMdsZhxBcOnM1ug9cz5GDx1TTEBAuXPzp8XrDkDOBfX3-In9_tsIxchi_uJT4GHDK-NN7hHPFZBy59dngF87DNcTCL13lZ3ZjhFV7h06nPgYSxhOQphziavmRvY8oP0T1venCP9vsRev_m9dX6HTk5e3u8Xp0QKxTNxIhN1wovWUdtU_vOd9XG0_ItlRFSitorr1rlWHmurIrwVrSCC6k6rpTopDhCz3a-2xRvJwdZDwGs63szujiBVpRXircL-PQf8CZOqVwYNGOMc1Er2RSK7SibIkByXm9TGEyaNaN6KU3vStOLXErTc5l5sneeusFt_kzsWyoA3wFQjsZrl_6K_q_rb5nHpDk</recordid><startdate>20080201</startdate><enddate>20080201</enddate><creator>Lee, C. J.</creator><creator>Scheiman, J.</creator><creator>Anderson, M. A.</creator><creator>Hines, O. J.</creator><creator>Reber, H. A.</creator><creator>Farrell, J.</creator><creator>Kochman, M. L.</creator><creator>Foley, P. J.</creator><creator>Drebin, J.</creator><creator>Oh, Y. S.</creator><creator>Ginsberg, G.</creator><creator>Ahmad, N.</creator><creator>Merchant, N. B.</creator><creator>Isbell, J.</creator><creator>Parikh, A. A.</creator><creator>Stokes, J. B.</creator><creator>Bauer, T.</creator><creator>Adams, R. B.</creator><creator>Simeone, D. 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J. ; Reber, H. A. ; Farrell, J. ; Kochman, M. L. ; Foley, P. J. ; Drebin, J. ; Oh, Y. S. ; Ginsberg, G. ; Ahmad, N. ; Merchant, N. B. ; Isbell, J. ; Parikh, A. A. ; Stokes, J. B. ; Bauer, T. ; Adams, R. B. ; Simeone, D. 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J.</au><au>Scheiman, J.</au><au>Anderson, M. A.</au><au>Hines, O. J.</au><au>Reber, H. A.</au><au>Farrell, J.</au><au>Kochman, M. L.</au><au>Foley, P. J.</au><au>Drebin, J.</au><au>Oh, Y. S.</au><au>Ginsberg, G.</au><au>Ahmad, N.</au><au>Merchant, N. B.</au><au>Isbell, J.</au><au>Parikh, A. A.</au><au>Stokes, J. B.</au><au>Bauer, T.</au><au>Adams, R. B.</au><au>Simeone, D. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2008-02-01</date><risdate>2008</risdate><volume>12</volume><issue>2</issue><spage>234</spage><epage>242</epage><pages>234-242</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract><![CDATA[Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this study was to determine the prevalence of malignancy in this group of patients using pancreatic resection databases from five high-volume pancreatic centers to assess the appropriateness of these guidelines. All pancreatic resections performed for cystic neoplasms ≤3 cm in size were evaluated over the time period of 1998–2006. One hundred sixty-six cases were identified, and the clinical, radiographic, and pathological data were reviewed. The correlation with age, gender, and symptoms (abdominal pain, nausea and vomiting, jaundice, presence of pancreatitis, unexplained weight loss, and anorexia), radiographic features suggestive of malignancy by either computed tomography, magnetic resonance imaging, or endoscopic ultrasound (presence of solid component, lymphadenopathy, or dilated main pancreatic duct or common bile duct), and the presence of malignancy was assessed using univariate and multivariate analysis. Among the 166 pancreatic resections for cystic pancreatic tumors ≤3 cm, 135 cases were benign [38 serous cystadenomas, 35 mucinous cystic neoplasms, 60 intraductal papillary mucinous neoplasms (IPMN), 1 cystic papillary tumor, and 1 cystic islet cell tumor], whereas 31 cases were malignant (14 mucinous cystic adenocarcinomas and 13 invasive carcinomas and 4 in situ carcinomas arising in the setting of IPMN). A greater incidence of cystic neoplasms was seen in female patients (99/166, 60%). Gender was a predictor of malignant pathology, with male patients having a higher incidence of malignancy (19/67, 28%) compared to female patients (12/99, 12%;
p
< 0.02). Older age was associated with malignancy (mean age 67 years in patients with malignant disease vs 62 years in patients with benign lesions (
p
< 0.05). A majority of the patients with malignancy were symptomatic (28/31, 90%). Symptoms that correlated with malignancy included jaundice (
p
< 0.001), weight loss (
p
< 0.003), and anorexia (
p
< 0.05). Radiographic features that correlated with malignancy were presence of a solid component (
p
< 0.0001), main pancreatic duct dilation (
p
= 0.002), common bile duct dilation (
p
< 0.001), and lymphadenopathy (
p
< 0.002). Twenty-seven of 31(87%) patients with malignant lesions had at least one radiographic feature concerning for malignancy. Forty-five patients (27%) were identified as having asymptomatic cystic neoplasms. All but three (6.6%) of the patients in this group had benign disease. Of the patients that had no symptoms and no radiographic features, 1 out of 30 (3.3%) had malignancy (carcinoma in situ arising in a side branch IPMN). Malignancy in cystic neoplasms ≤3 cm in size was associated with older age, male gender, presence of symptoms (jaundice, weight loss, and anorexia), and presence of concerning radiographic features (solid component, main pancreatic duct dilation, common bile duct dilation, and lymphadenopathy). Among asymptomatic patients that displayed no discernable radiographic features suggestive of malignancy who underwent resection, the incidence of occult malignancy was 3.3%. This study suggests that a group of patients with small cystic pancreatic neoplasms who have low risk of malignancy can be identified, and selective resection of these lesions may be appropriate.]]></abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18040749</pmid><doi>10.1007/s11605-007-0381-y</doi><tpages>9</tpages></addata></record> |
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| ispartof | Journal of gastrointestinal surgery, 2008-02, Vol.12 (2), p.234-242 |
| issn | 1091-255X 1873-4626 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70247295 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Age Aged Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - surgery Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Cystadenoma, Serous - pathology Cystadenoma, Serous - surgery Female Gastroenterology Gender Humans Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Pancreas Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Pancreaticoduodenectomy Retrospective Studies Risk Factors SSAT plenery presentation Surgery Tumors |
| title | Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T20%3A10%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20of%20Malignancy%20in%20Resected%20Cystic%20Tumors%20of%20the%20Pancreas%20%E2%89%A43%C2%A0cm%20in%20Size:%20Is%20it%20Safe%20to%20Observe%20Asymptomatic%20Patients?%20A%20Multi-institutional%20Report&rft.jtitle=Journal%20of%20gastrointestinal%20surgery&rft.au=Lee,%20C.%20J.&rft.date=2008-02-01&rft.volume=12&rft.issue=2&rft.spage=234&rft.epage=242&rft.pages=234-242&rft.issn=1091-255X&rft.eissn=1873-4626&rft_id=info:doi/10.1007/s11605-007-0381-y&rft_dat=%3Cproquest_cross%3E70247295%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1112236758&rft_id=info:pmid/18040749&rfr_iscdi=true |