A0006 - Veterans With Pancreatic Cysts, on the Road to Cancer? A 22-Year Retrospective Analysis

Abu F. Abbasi, MD¹, Joshua Kalapala, BSc², Stephen Sontag, MD, FACG³, Jack Leya, MD⁴, Thomas Schnell, MD⁴, John Losurdo, MD⁴, Promila Banerjee, MD, FACG^3
1Loyola University Medical Center, Villa Park, IL; ²Loyola University Stritch School of Medicine, Maywood, IL; ³Hines VA Hospital/Loyola University Stritch School of Medicine, Hines, IL; ⁴Edward Hines, Jr. VA Hospital/Loyola University Chicago Stritch School of Medicine, Hines, IL

Introduction: Increased use of CT and MRI has increased detection rates of pancreatic cysts up to 15%.. Currently there is a lack of agreement on how best to survey incidental pancreatic cysts. We aim to evaluate the natural history of pancreatic cyst amongst veterans with the goal of ultimately reducing the risk of pancreatic cancer. This is one of the first analyses of the natural history of pancreatic cyst exploring the long term data, EUS findings, and surgical versus non-surgical outcomes.

Methods: A retrospective chart review from 2000 - 2022 is being conducted on Hines VA Veterans with pancreatic cyst utilizing Computerized Patient Record System. CPT codes retrieved EUS and ERCP data. Veterans not diagnosed with incidental pancreatic cyst were excluded from the study. SPSS software used to conduct Chi-square analysis, ANOVA test and log rank test to compare survival curves amongst different causes of death. Prevalent cancer is presence of cancer at the time of cyst diagnosis.

Results: This is an ongoing study of 1905 veterans that underwent EUS, the total number with pancreatic cysts is yet to be determined. Preliminary analysis and demographics of initial charts are presented in Table 1. The causes of mortality for veterans with pancreatic cyst are shown in the pie diagram in Figure A. Important to note that only 3% of veterans with pancreatic cysts developed incidental pancreatic cancer and only 1.5% died of pancreatic cancer. Kaplan-Myer Survival Curve shown in Figure B of 113 patients.

Discussion: Our study population is geriatric with a high comorbidity index, high rates of smoking, alcoholism, and high rates of non-pancreatic cancers. Despite these poor prognostic factors, our preliminary data of incidental cancer developing from cysts was 3%. Non-pancreatic cancer and cardiovascular causes are seen as the two most common causes of death. Most incidental cancers were detected within two years of cyst presentation, reinforcing the need for initial surveillance. Since no cumulative increase of pancreatic cancers were observed long-term, surveillance may need to be adjusted accordingly. The findings of this study could lead to guideline enhancement, cost-effective surveillance and surgical resection strategies for pancreatic cysts. As it is an ongoing study additional charts were reviewed and demographics, patient results and causes of mortality pie diagrams were generated on 133 patients. Complete results and analysis will be presented in October 2022.




Disclosures:


Abu F. Abbasi, MD¹, Joshua Kalapala, BSc², Stephen Sontag, MD, FACG³, Jack Leya, MD⁴, Thomas Schnell, MD⁴, John Losurdo, MD⁴, Promila Banerjee, MD, FACG³. A0006 - Veterans With Pancreatic Cysts, on the Road to Cancer? A 22-Year Retrospective Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.