Mucinous cystic neoplasms of the pancreas : A surgical disease
Menée à partir de données portant sur 349 patients présentant une tumeur kystique mucineuse traitée par résection entre 2000 et 2014, cette étude multicentrique identifie les facteurs pré-opératoires associés au risque d'adénocarcinome ou de dysplasie de haut grade, puis analyse la survie des patients ayant développé un adénocarcinome lié à la tumeur kystique mucineuse
Postlewait and coworkers are to be congratulated for their multicenter study with its detailed statistical analysis. The strengths of their study are the large number of patients and the basic confirmation of risk factors associated with high-grade dysplasia or invasive cancer—with both having to be regarded as “malignant”—in MCNs. A controversy, which cannot be precisely clarified by the authors, is the matter of size. Although larger MCNs seem to be at a higher risk of being malignant, there is no clear cutoff, especially with regard to thresholds that were recommended in the past (ie, 4 cm) as a predictor of malignancy. Interestingly, MCNs with a diameter of less than 3 cm also showed malignancy in the present series. From this finding, it becomes evident that size is not the criteria for clinical decision making in the management of MCNs.
JAMA Surgery 2016