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Your search keyword '"Hossain, Mir Shanaz"' showing total 24 results
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24 results on '"Hossain, Mir Shanaz"'

10. Consequences of a Surveillance Strategy for Side-branch Intraductal Pancreatic Mucinous Neoplasms: Long-term Follow-up of One Thousand Cysts.

Author

Wehrle, Chase J., Hossain, Mir Shanaz, Perlmutter, Breanna, Chang, Jenny H., Joyce, Daniel, Simon, Robert, Augustin, Toms, and Walsh, R. Matthew

Abstract

Objective: To quantify the rate of progression in surveilled cysts and assess what factors should indicate delayed resection. Background: Side-branch intraductal papillary mucinous neoplasms (SB-IPMNs) are increasingly discovered, making it challenging to identify which patients require resection, thus avoiding inappropriate treatment. Most incidental lesions are surveyed, yet the consequences of that decision remain uncertain. Methods: A prospectively maintained database of pancreatic cystic neoplasms was queried for patients with SB-IPMN. Patients with ≥ 2 imaging studies >6 months apart were included. Clinically relevant progression (CR-progression) was defined by symptoms, worrisome/high-risk stigmata, or invasive cancer (IC). Growth ≥ 5 mm in 2 years is considered CR-progression; size ≥3 cm alone is not. Results: Between 1997 and 2023, 1337 patients were diagnosed with SB-IPMN. Thirty-seven (2.7%) underwent up-front surgery; 1000 (75.0%) had >6 months of surveillance. The rate of CR-progression was 15.3% (n = 153) based on size increase (n = 63, 6.3%), mainduct involvement (n = 48, 4.8%), symptoms (n = 8, 5.0%), or other criteria (n = 34, 3.4%). At a median follow-up of 6.6 years (interquartile range: 3.0-10.26), 17 patients (1.7%) developed IC. Those with CR-progression developed IC in 11.1% (n = 17) and highgrade dysplasia (HGD) in 6.5% (n = 10). Nearly half of the cancers were not contiguous with the surveyed SB-IPMN. Size ≥3 cm was not associated with HGD/IC (P = 0.232). HGD/IC was least common in CR-progression determined by size growth (6.3%) versus main-duct involvement (24%) or other (43%, P < 0.001) Patients with CR-progression demonstrated improved survival (overall survival) with resection on time-to-event (P < 0.001) and multivariate Cox regression (hazard ratio = 0.205, 0.096-0.439, P < 0.001) analyses. Overall survival was not improved with resection in all patients (P = 0.244). Conclusions: CR-progression for SB-IPMNs is uncommon, with the development of cancer anywhere in the pancreas being rare. Initial size should not drive resection. Long-term and consistent nonoperative surveillance is warranted, with surgery currently reserved for CR-progression, knowing that the majority of these still harbor low-grade pathology. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Mo1259: SURGICALLY RESECTED INTRADUCTAL PAPILLARY MUCINOUS NEOPLASM: IS LONG-TERM SURVEILLANCE WARRANTED?

Author

Saleh, Mohannad Abou, primary, Hossain, Mir Shanaz, additional, Said, Sayf Al-deen, additional, Perlmutter, Breanna, additional, Alkhayyat, Motasem, additional, Martin, Charles, additional, Mcmichael, John, additional, Simons-Linares, Roberto, additional, Simon, Robert, additional, Joyce, Daniel, additional, Augustin, Toms, additional, Chahal, Prabhleen, additional, and Walsh, R Matthew, additional

Published
2022
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23. Tumor Size Combined With CA-19 Level Improves Prediction of Survival of Patients With Pancreatic Adenocarcinoma Undergoing Perioperative Chemotherapy and Resection

Author

Said, Sayf A., Perlmutter, Breanna C., Wehrle, Chase J., Chang, Jenny, Hossain, Mir Shanaz, Naffouje, Samer, Joyce, Daniel, Simon, Robert, Walsh, R. Matthew, and Augustin, Toms

Abstract

Background and Objective Five-year survival in pancreatic adenocarcinoma is less than 20%. While previous studies have postulated that a carbohydrate antigen 19-9 (CA19-9) threshold could predict outcome of resection, the role for CA19-9 in decision-making remains unclear. This study aims to assess whether CA19-9 levels combined with tumor size improve prediction of post-resection survival.Method A retrospective analysis was conducted on 109 patients with pancreatic adenocarcinoma who underwent perioperative chemotherapy followed by resection. The primary outcome of mortality was, divided into short (<1 year) or prolonged (>2 years). Univariate and multivariable analyses compared the tumor size-adjusted CA19-9 between the outcome groups.Results Twenty-seven (24.78%) and eighty-two (75.23%) patients were in the short survival and prolonged-survival groups, respectively. The mean CA19-9 was significantly greater in the short vs prolonged group (P< .001). Analyzing CA19-9 level by tumor size, the association of high CA19-9 and short survival was significant for small (≤2 cm) and large tumor (>4 cm), but not for intermediate-size tumors (2-4 cm). Adjusting for preoperative variable did not change this association.Conclusion CA 19-9 in combination with tumor size better identifies patients with prolonged post-resection survival. This prediction is most accurate in patients with either small (≤2 cms) or large (>4 cms) tumors compared to intermediate-size tumors.

Published
2024
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