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Predictors for Surgical Referral in Patients With Pancreatic Cystic Lesions Undergoing Endoscopic Ultrasound: Results From a Large Multicenter Cohort Study.
- Source :
-
Pancreas [Pancreas] 2016 Jan; Vol. 45 (1), pp. 51-7. - Publication Year :
- 2016
-
Abstract
- Objective: Endoscopic ultrasound (EUS) plays an integral role in the evaluation of pancreatic cysts lesions (PCLs). The aim of the study was to determine predictors of surgical referral in patients with PCLs undergoing EUS.<br />Methods: We performed a multicenter retrospective study of patients undergoing EUS for evaluation of PCLs. Demographics, EUS characteristics, and fine-needle aspiration results were recorded. Patients were categorized into surgery or surveillance groups on the basis of post-EUS recommendations. Univariate and multivariate analyses were performed to identify predictors of surgical referral.<br />Results: 1804 patients were included. 1301 patients were recommended to undergo surveillance and 503 patients were referred for surgical evaluation, of which 360 patients underwent surgery. Multivariate analysis revealed the following 5 independent predictors of surgical referral: symptoms of weight loss on presentation (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.44-5.03), EUS findings of associated solid mass (OR, 7.34; 95% CI, 3.81-14.16), main duct communication (OR, 4.13; 95% CI, 1.71-9.98), multilocular macrocystic morphology (OR, 2.79; 95% CI, 1.78-4.38), and fine-needle aspiration findings of mucin on cytology (OR, 3.06; 95% CI, 1.94-4.82).<br />Conclusions: This study identifies factors associated with surgical referral in patients with PCLs undergoing EUS. Future studies should focus on creation of risk stratification models to determine the need for surgery or enrollment in surveillance programs.
- Subjects :
- Aged
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
United States
Watchful Waiting
Endosonography
Neoplasms, Cystic, Mucinous, and Serous diagnostic imaging
Neoplasms, Cystic, Mucinous, and Serous surgery
Pancreatectomy
Pancreatic Cyst diagnostic imaging
Pancreatic Cyst surgery
Pancreatic Neoplasms diagnostic imaging
Pancreatic Neoplasms surgery
Pancreaticoduodenectomy
Referral and Consultation
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4828
- Volume :
- 45
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Pancreas
- Publication Type :
- Academic Journal
- Accession number :
- 26262589
- Full Text :
- https://doi.org/10.1097/MPA.0000000000000386