An updated review about the possibility of surveillance strategy in non-resected mucinous cystic neoplasms.

Abstract

After the World Health Organization established a precise definition of mucinous cystic neoplasm (MCN) in 2000, based on the presence of ovarian-type stroma, its clinical features became more apparent. Surgery for MCN, which primarily affects middle-aged women with long life expectancies, is likely to negatively impact the patient's quality of life. Although recent studies have reported a low proportion of advanced neoplasia among resected MCN (≤15%), many clinicians still recommend surgery for patients with presumed MCN without considering risk stratification for advanced neoplasia. Recent studies have demonstrated that, when appropriate patient groups are established based on high-risk characteristics, there is no difference in long-term prognosis between a surveillance strategy and surgery. Additionally, while most guidelines do not recommend post-resection surveillance for MCN, research indicates that surveillance of non-resected MCN is more cost-effective than surgery when considering the expenses of post-pancreatectomy diabetic care. It is time to carefully consider a surveillance strategy, despite the significant misdiagnosis rates associated with MCN diagnosis based solely on imaging without histology.