The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males: An eight-institution study of 349 patients over 15 years

Cecilia G. Ethun, Lauren M. Postlewait, Mia R. Mcinnis, Nipun Merchant, Alexander Parikh, Kamran Idrees, Chelsea A. Isom, William Hawkins, Ryan C. Fields, Matthew Strand, Sharon M. Weber, Clifford S. Cho, Ahmed Salem, Robert C G Martin, Charles R. Scoggins, David Bentrem, Hong J. Kim, Jacquelyn Carr, Syed A. Ahmad, Daniel E. AbbottGregory Wilson, David A. Kooby, Shishir K. Maithel

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods. Primary aim was to characterize MCN and associated adenocarcinoma/high-grade-dysplasia (AC/HGD) in males versus females over time. RESULTS: Of 1667 resections for pancreatic cystic lesions, 349pts (21%) had MCNs: 310 (89%) female, 39 (11%) male. Patients were equally divided between early (n=173) and late (n=176) time-periods. MCN in male-patients decreased over time (early: 15%, late: 7%; P=0.036), as did pancreatic head/neck location (early: 22%, late: 11%; P=0.01). MCN-associated AC/HGD was more frequent in males versus females (39 vs. 12%; P<0.001). The overall rate of MCN-associated AC/HGD remained stable (early: 17%, late: 13%; P=0.4), and was identical in males (39%) over both time-periods. Males with AC/HGD had more LN-positive disease versus females (57 vs. 22%; P=0.039). CONCLUSIONS: As the diagnostic-criteria of MCN have standardized over time, MCN diagnosis has decreased in males and head/neck location. Despite this, MCN-associated adenocarcinoma/high-grade dysplasia has been stable and remains high in males. Any male with suspected MCN, regardless of location, should undergo resection.

Original languageEnglish (US)
JournalJournal of Surgical Oncology
DOIs
StateAccepted/In press - 2017

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Adenocarcinoma
Neoplasms
Neck
Pancreas
Head
Incidence

Keywords

  • High-grade dysplasia
  • Ovarian stroma
  • Surgical resection

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males : An eight-institution study of 349 patients over 15 years. / Ethun, Cecilia G.; Postlewait, Lauren M.; Mcinnis, Mia R.; Merchant, Nipun; Parikh, Alexander; Idrees, Kamran; Isom, Chelsea A.; Hawkins, William; Fields, Ryan C.; Strand, Matthew; Weber, Sharon M.; Cho, Clifford S.; Salem, Ahmed; Martin, Robert C G; Scoggins, Charles R.; Bentrem, David; Kim, Hong J.; Carr, Jacquelyn; Ahmad, Syed A.; Abbott, Daniel E.; Wilson, Gregory; Kooby, David A.; Maithel, Shishir K.

In: Journal of Surgical Oncology, 2017.

Research output: Contribution to journalArticle

Ethun, CG, Postlewait, LM, Mcinnis, MR, Merchant, N, Parikh, A, Idrees, K, Isom, CA, Hawkins, W, Fields, RC, Strand, M, Weber, SM, Cho, CS, Salem, A, Martin, RCG, Scoggins, CR, Bentrem, D, Kim, HJ, Carr, J, Ahmad, SA, Abbott, DE, Wilson, G, Kooby, DA & Maithel, SK 2017, 'The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males: An eight-institution study of 349 patients over 15 years', Journal of Surgical Oncology. https://doi.org/10.1002/jso.24582
Ethun, Cecilia G. ; Postlewait, Lauren M. ; Mcinnis, Mia R. ; Merchant, Nipun ; Parikh, Alexander ; Idrees, Kamran ; Isom, Chelsea A. ; Hawkins, William ; Fields, Ryan C. ; Strand, Matthew ; Weber, Sharon M. ; Cho, Clifford S. ; Salem, Ahmed ; Martin, Robert C G ; Scoggins, Charles R. ; Bentrem, David ; Kim, Hong J. ; Carr, Jacquelyn ; Ahmad, Syed A. ; Abbott, Daniel E. ; Wilson, Gregory ; Kooby, David A. ; Maithel, Shishir K. / The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males : An eight-institution study of 349 patients over 15 years. In: Journal of Surgical Oncology. 2017.
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title = "The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males: An eight-institution study of 349 patients over 15 years",
abstract = "BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods. Primary aim was to characterize MCN and associated adenocarcinoma/high-grade-dysplasia (AC/HGD) in males versus females over time. RESULTS: Of 1667 resections for pancreatic cystic lesions, 349pts (21{\%}) had MCNs: 310 (89{\%}) female, 39 (11{\%}) male. Patients were equally divided between early (n=173) and late (n=176) time-periods. MCN in male-patients decreased over time (early: 15{\%}, late: 7{\%}; P=0.036), as did pancreatic head/neck location (early: 22{\%}, late: 11{\%}; P=0.01). MCN-associated AC/HGD was more frequent in males versus females (39 vs. 12{\%}; P<0.001). The overall rate of MCN-associated AC/HGD remained stable (early: 17{\%}, late: 13{\%}; P=0.4), and was identical in males (39{\%}) over both time-periods. Males with AC/HGD had more LN-positive disease versus females (57 vs. 22{\%}; P=0.039). CONCLUSIONS: As the diagnostic-criteria of MCN have standardized over time, MCN diagnosis has decreased in males and head/neck location. Despite this, MCN-associated adenocarcinoma/high-grade dysplasia has been stable and remains high in males. Any male with suspected MCN, regardless of location, should undergo resection.",
keywords = "High-grade dysplasia, Ovarian stroma, Surgical resection",
author = "Ethun, {Cecilia G.} and Postlewait, {Lauren M.} and Mcinnis, {Mia R.} and Nipun Merchant and Alexander Parikh and Kamran Idrees and Isom, {Chelsea A.} and William Hawkins and Fields, {Ryan C.} and Matthew Strand and Weber, {Sharon M.} and Cho, {Clifford S.} and Ahmed Salem and Martin, {Robert C G} and Scoggins, {Charles R.} and David Bentrem and Kim, {Hong J.} and Jacquelyn Carr and Ahmad, {Syed A.} and Abbott, {Daniel E.} and Gregory Wilson and Kooby, {David A.} and Maithel, {Shishir K.}",
year = "2017",
doi = "10.1002/jso.24582",
language = "English (US)",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
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TY - JOUR

T1 - The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males

T2 - An eight-institution study of 349 patients over 15 years

AU - Ethun, Cecilia G.

AU - Postlewait, Lauren M.

AU - Mcinnis, Mia R.

AU - Merchant, Nipun

AU - Parikh, Alexander

AU - Idrees, Kamran

AU - Isom, Chelsea A.

AU - Hawkins, William

AU - Fields, Ryan C.

AU - Strand, Matthew

AU - Weber, Sharon M.

AU - Cho, Clifford S.

AU - Salem, Ahmed

AU - Martin, Robert C G

AU - Scoggins, Charles R.

AU - Bentrem, David

AU - Kim, Hong J.

AU - Carr, Jacquelyn

AU - Ahmad, Syed A.

AU - Abbott, Daniel E.

AU - Wilson, Gregory

AU - Kooby, David A.

AU - Maithel, Shishir K.

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods. Primary aim was to characterize MCN and associated adenocarcinoma/high-grade-dysplasia (AC/HGD) in males versus females over time. RESULTS: Of 1667 resections for pancreatic cystic lesions, 349pts (21%) had MCNs: 310 (89%) female, 39 (11%) male. Patients were equally divided between early (n=173) and late (n=176) time-periods. MCN in male-patients decreased over time (early: 15%, late: 7%; P=0.036), as did pancreatic head/neck location (early: 22%, late: 11%; P=0.01). MCN-associated AC/HGD was more frequent in males versus females (39 vs. 12%; P<0.001). The overall rate of MCN-associated AC/HGD remained stable (early: 17%, late: 13%; P=0.4), and was identical in males (39%) over both time-periods. Males with AC/HGD had more LN-positive disease versus females (57 vs. 22%; P=0.039). CONCLUSIONS: As the diagnostic-criteria of MCN have standardized over time, MCN diagnosis has decreased in males and head/neck location. Despite this, MCN-associated adenocarcinoma/high-grade dysplasia has been stable and remains high in males. Any male with suspected MCN, regardless of location, should undergo resection.

AB - BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods. Primary aim was to characterize MCN and associated adenocarcinoma/high-grade-dysplasia (AC/HGD) in males versus females over time. RESULTS: Of 1667 resections for pancreatic cystic lesions, 349pts (21%) had MCNs: 310 (89%) female, 39 (11%) male. Patients were equally divided between early (n=173) and late (n=176) time-periods. MCN in male-patients decreased over time (early: 15%, late: 7%; P=0.036), as did pancreatic head/neck location (early: 22%, late: 11%; P=0.01). MCN-associated AC/HGD was more frequent in males versus females (39 vs. 12%; P<0.001). The overall rate of MCN-associated AC/HGD remained stable (early: 17%, late: 13%; P=0.4), and was identical in males (39%) over both time-periods. Males with AC/HGD had more LN-positive disease versus females (57 vs. 22%; P=0.039). CONCLUSIONS: As the diagnostic-criteria of MCN have standardized over time, MCN diagnosis has decreased in males and head/neck location. Despite this, MCN-associated adenocarcinoma/high-grade dysplasia has been stable and remains high in males. Any male with suspected MCN, regardless of location, should undergo resection.

KW - High-grade dysplasia

KW - Ovarian stroma

KW - Surgical resection

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U2 - 10.1002/jso.24582

DO - 10.1002/jso.24582

M3 - Article

C2 - 28211072

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JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

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