Table 1.
Key Features of pancreatic cyst guidelines
Specifics of Guidelines
|
2015 AGA
|
2017 Fukuoka
|
2017 ACG
|
2017 ACR
|
2018 European Study Group
|
Patient population | Incidental pancreatic cysts | Suspected MCN and IPMN | All pancreatic cysts | Incidental pancreatic cysts | All pancreatic cysts |
Threshold for EUS and/or surgery | At least 2 risk factors | 1 risk factor | 1 risk factor | 1 risk factor | 1 risk factor |
Surveillance recommendations in unresected cysts | MRI in 1 year, then every 2 yr | Surveillance based on cyst size | Surveillance based on cyst size | Surveillance based on cyst size and age | Surveillance based on cyst size and diagnosis |
Stopping surveillance | (1) After 5 yr of stability without development of high-risk features; (2) Surgically unfit; and (3) Select resected cysts including BD-IPMN with no, low or moderate-grade dysplasia | (1) Surgically unfit; and (2) Following resection of serous cystadenoma and MCN without invasive cancer | (1) Surgically unfit; (2) Following resection of serous cystadenoma and MCN without invasive cancer; and (3) Individualize approach to patients > 75 | (1) 9-10 yr and stop at age 80; and (2) For cysts discovered > age 80, limited surveillance for 4 yr only if stable | Surgically unfit |
AGA: American Gastroenterological Association; ACG: American College of Gastroenterology; EUS: Endoscopic ultrasound; MRI: Magnetic resonance imaging; MCN: Mucinous cystic neoplasm; IPMN: Intraductal papillary mucinous neoplasm; BD-IPMN: Branch duct-intraductal papillary mucinous neoplasm.