Association of preoperative risk factors with malignancy in pancreatic mucinous cystic neoplasms a multicenter study

Abstract

IMPORTANCE Pancreatic mucinous cystic neoplasms (MCNs) harbor malignant potential, and current guidelines recommend resection. However, data are limited on preoperative risk factors for malignancy (adenocarcinoma or high-grade dysplasia) occurring in the setting of an MCN. OBJECTIVES To examine the preoperative risk factors for malignancy in resected MCNs and to assess outcomes of MCN-Associated adenocarcinoma. DESIGN, SETTING, AND PARTICIPANTS Patients who underwent pancreatic resection of MCNs at the 8 academic centers of the Central Pancreas Consortium from January 1, 2000, through December 31, 2014, were retrospectively identified. Preoperative factors of patients with and without malignant tumors were compared. Survival analyses were conducted for patients with adenocarcinoma. MAIN OUTCOMES AND MEASURES Binary logistic regression modelswere used to determine the association of preoperative factors with the presence of MCN-Associated malignancy. RESULTS A total of 1667 patients underwent resection of pancreatic cystic lesions, and 349 (20.9%) had an MCN (310 women [88.8%]; mean (SD) age, 53.3 [14.7] years). Male sex (odds ratio [OR], 3.72; 95%CI, 1.21-11.44; P = .02), pancreatic head and neck location (OR, 3.93; 95%CI, 1.43-10.81; P = .01), increased radiographic size of the MCN (OR, 1.17; 95%CI, 1.08-1.27; P < .001), presence of a solid component or mural nodule (OR, 4.54; 95%CI, 1.95-10.57; P