Growth pattern of serous cystic neoplasms of the pancreas: observational study with long-term magnetic resonance...

Area of Science:

• Gastroenterology
• Oncology
• Radiology

Background:

• Pancreatic serous cystic neoplasms (SCNs) are tumors with poorly understood natural history and growth patterns.
• Accurate assessment of SCN growth is crucial for effective patient management and treatment decisions.

Purpose of the Study:

• To investigate the growth rate of SCNs using longitudinal data.
• To identify factors influencing SCN growth and inform clinical management recommendations.

Main Methods:

• Analysis of 145 patients with SCNs undergoing yearly surveillance MRI.
• Application of a linear mixed model to assess tumor growth rate and influencing factors (sex, malignancy history, radiological pattern, clinical presentation, tumor site, age, initial tumor diameter).

Main Results:

• Overall mean SCN growth rate was 0.28 cm/year, with a slower rate (0.1 cm/year) in the first 7 years and accelerated growth (0.6 cm/year) thereafter (p<0.0001).
• Oligocystic/macrocystic pattern (0.34 cm/year), history of other malignancies (0.34 cm/year), and increasing age were significant predictors of faster growth (p<0.0001, p=0.022, p=0.0001, respectively).

Conclusions:

• SCNs exhibit slow growth, supporting a conservative, non-operative approach for asymptomatic or minimally symptomatic patients.
• Tumor characteristics (oligocystic/macrocystic variant), patient history (other malignancies), and age are key determinants of SCN growth.
• Significant growth is unlikely within the first 7 years; tumor size at diagnosis is not a reliable factor for management decisions.