University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland, OH
Award: Presidential Poster Award
Shaina Ailawadi, MD1, Abbinaya Elangovan, MD1, Mart Andrew Maravillas, MS2, Amitabh Chak, MD3, Andrew Catanzaro, MD3 1University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH; 2University Hospitals Cleveland Medical Center, Akron, OH; 3Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
Introduction: Although guidelines for pancreatic cyst surveillance have been established, there are currently no guidelines on surveillance cessation. In elderly patients with new diagnoses of pancreatic cystic lesions (PCL) with low-risk features (LRF), it is unclear whether there is any benefit of PCL surveillance. Our study aimed to determine the incidence of pancreatic cancer and all-cause mortality in patients over 70-years-old with new diagnosis of low-risk PCL.
Methods: A retrospective chart review was performed at our tertiary care referral center from 2013-2023 to identify patients >70-years-old diagnosed with new PCLs by CT/MRI. After exclusion of prior pancreatic malignancy and pancreatic resections, 333 patients were identified. Among them, 214 patients with PCLs that had an absence of high-risk criteria (defined by Fukuoka guidelines). This cohort was further divided into two groups: no-repeat imaging (NRI) group (n=123) with no further imaging after identification of PCL, and the repeat imaging (RI) group (n=91) with patients who had one or more CT/MRI after the diagnosis of PCL (Table 1). Pancreatic cancer incidence and all-cause mortality were compared between the groups.
Results: No cases of pancreatic cancer were identified in either group. There was also no significant difference in all-cause mortality between the two groups (HR 0.68, 0.35-1.31, p=0.20). The mean age of diagnosis was 90.97 + 6.16 years and the mean follow-up in patient years was 3.76 for the RI group and 2.17 for the NRI group. For every unit increase in Charlson Comorbidity Index, all-cause mortality increased by 1.26 times (p< 0.001).
Discussion: Our study demonstrates no benefit in disease specific or all-cause mortality in patients >70 years with new PCL of LRF who underwent repeat imaging. Surveillance of pancreatic cysts with low risk features in individuals over age 70 should not be recommended.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Shaina Ailawadi indicated no relevant financial relationships.
Abbinaya Elangovan indicated no relevant financial relationships.
Mart Andrew Maravillas indicated no relevant financial relationships.
Andrew Catanzaro indicated no relevant financial relationships.
Shaina Ailawadi, MD1, Abbinaya Elangovan, MD1, Mart Andrew Maravillas, MS2, Amitabh Chak, MD3, Andrew Catanzaro, MD3. P1751 - Surveillance of Low-Risk Pancreatic Cysts is not Beneficial in Older Patients: A Retrospective Cohort Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
