Small (Sendai Negative) Branch-Duct IPMNs

Fritz, Stefan; Klauß, Miriam; Bergmann, Frank; Hackert, Thilo; Hartwig, Werner; Strobel, Oliver; Bundy, Bogata D.; Büchler, Markus W.; Werner, Jens

doi:10.1097/sla.0b013e31825d355f

Cited by 199 publications

(111 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, a recent, somewhat controversial paper from the surgical group in Heidelberg, Germany, has defined a 24.6 % incidence of malignancy in "Sendai-negative" branch-duct IPMNs with 15.9 % of all such tumors harboring invasive cancer. 3 Interestingly, the incidence of malignancy in the Heidelberg report is nearly identical to the reported incidence of cancer in a series of resected highly selected branch-duct IPMNs published by these two debaters. 4,5 This debate will obviously continue and may intensify as surgeons and gastroenterologists care for an ever increasing number of these patients with pancreatic cystic neoplasms, often as incidental findings.…”

supporting

confidence: 64%

“A Debate: Is Surgical Intervention for Cystic Neoplasms of the Pancreas Being Overutilized”

Lillemoe

2014

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

supporting

confidence: 64%

“A Debate: Is Surgical Intervention for Cystic Neoplasms of the Pancreas Being Overutilized”

Lillemoe

2014

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

“…A cut-off value for a lesion's size regarding its malignant potential could not be found, so size is of no help for the prediction of malignancy. 23 The 2006 ICG 3 were very clear in giving advice based on radiological data recommending resection or not. This has been convoluted with the release of the ICG of 2012 4 by the introduction of "worrisome features" vs "high-risk stigmata" without a clear-cut guideline whether to resect the tumour.…”

Section: Discussionmentioning

confidence: 99%

Intraductal papillary mucinous neoplasms of the pancreas: radiological predictors of malignant transformation and the introduction of bile duct dilation to current guidelines

Strauss¹,

Birdsey²,

Fritz³

et al. 2016

BJR

Self Cite

View full text Add to dashboard Cite

“…More challenging is the diagnosis of a single cystic lesion, as it may prove difficult to confidently exclude a series of differentials. For this reason, some authors suggested enucleation of these lesions as a combined diagnostic and therapeutic option in selected cases [19,20] . Currently, in absence of risk factors for malignancy and/or worrisome features on radiological assessment, cystic lesions of the pancreas (IPMN and MCN) can be conservatively treated as long as the diameter does not exceed 4 cm [17] .…”

Section: Editorialmentioning

confidence: 99%

Cystic tumors of the pancreas: Opportunities and risks

Chiaro

Verbeke

2015

WJGP

View full text Add to dashboard Cite

neoplasms of the pancreas can be considered as the pancreatic analogon to colonic polyps. Treatment of these precursor lesions at an early stage can potentially reduce pancreas cancer mortality and introduce a new "era" of preemptive pancreatic surgery. However, only few of those lesions have an aggressive behavior. The accuracy of preoperative diagnosis, i.e. , the distinction between the various PCNs is around 60%, and the ability to predict the future outcome is also less accurate. For this reason, a significant number of patients are currently over-treated with an unnecessary, high-risk surgery. Furthermore, the majority of patients with PCN are on life-long follow-up with imaging modality, which has huge cost implications for the Health Care System for limited benefits considering that a significant proportion of PCNs are or behave like benign lesions. The current guidelines for the diagnosis and management of PCNs are more based on expert opinion than on evidence. For all those reasons, the management of cystic tumors of the pancreas remains a controversial area of pancreatology. On one hand, the detection of PCNs and the surgical treatment of pre-cancerous neoplasms can be considered a big opportunity to reduce pancreatic cancer related mortality. On the other hand, PCNs are associated with a considerable risk of under-or over-treatment of patients and incur high costs for the Health Care System. Core tip: The present paper is an editorial focused on the critical problems regarding the management strategy of pancreatic cystic neoplasms (PCNs). Being a pre-cancerous condition in most of the cases, PCNs represent a unique opportunity to prevent pancreatic cancer and to develop preemptive pancreatic surgery programs. However, the lack of predictive factors of the behaviour of these lesions, the low accuracy of AbstractPancreatic cystic neoplasms (PCNs) are a high prevalence disease. It is estimated that about 20% of the general population is affected by PCNs. Some of those lesions can progress till cancer, while others behave in a benign fashion. In particular intraductal papillary mucinous 29May 15, 2015|Volume 6|Issue 2|

show abstract

Small (Sendai Negative) Branch-Duct IPMNs

Cited by 199 publications

References 24 publications

“A Debate: Is Surgical Intervention for Cystic Neoplasms of the Pancreas Being Overutilized”

“A Debate: Is Surgical Intervention for Cystic Neoplasms of the Pancreas Being Overutilized”

Intraductal papillary mucinous neoplasms of the pancreas: radiological predictors of malignant transformation and the introduction of bile duct dilation to current guidelines

Cystic tumors of the pancreas: Opportunities and risks

Contact Info

Product

Resources

About