New test to guide the management of cysts in the pancreas

Cysts (collections of fluid caused by small tumors) of the pancreas present a real clinical challenge. While most are entirely harmless, some are precancerous and, if left untreated progress over time to pancreatic cancer. The problem is that it can be hard for doctors to know which cysts should be removed surgically and which are safe to follow without surgery. In the July 17th issue of the journal Science Translational Medicine (https://stm.sciencemag.org/content/11/501/eaav4772.short), S. Springer and colleagues in the Sol Goldman Pancreatic Cancer Research Center report a new approach that could help guide the clinical management of patients with a cyst in their pancreas. The test, called “CompCyst” integrates a combination of clinical features, imaging findings, and cyst fluid genetics. Tested on over 400 patients, CompCyst proved to be much more accurate than just the clinician’s judgement on whether or not a cyst needs to be removed surgically. The authors concluded that “application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices.” This test is not available yet as an approved clinical test, but pathologists in the Goldman Center are working to bring a clinical test to practice.

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