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Pancreatic Neoplasms: HELP
Articles by Maria Moris
Based on 7 articles published since 2008
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Between 2008 and 2019, Maria Moris wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Intraductal papillary mucinous neoplasms and mucinous cystadenomas: current status and recommendations. 2017

Moris, Maria / Wallace, Michael B. ·Gastroenterology, Mayo Clinic, Canadá. · Gastroenterology, Mayo Clinic, USA. ·Rev Esp Enferm Dig · Pubmed #28112959.

ABSTRACT: The real prevalence of pancreatic cystic lesions remains unknown. The malignant potential of some of these lesions remains a cause for significant concern. Thus, it is mandatory to develop a strategy to clearly discriminate those cysts with a potential for malignant transformation from those that do not carry any significant risk. Intraductal papillary mucinous neoplasms and mucinous cystadenomas are mucinous cystic neoplasms with a known malignant potential that have gained greater recognition in recent years. However, despite the numerous studies that have been carried out, their differential diagnosis among other cysts subtypes and their therapeutic approach continue to be a challenge for clinicians. This review contains a critical approach of the current recommendations and management strategies regarding intraductal papillary mucinous neoplasms and mucinous cystadenomas, as well as highlighting the limitations exposed in current guidelines.

2 Article Predictors of Progression Among Low-Risk Intraductal Papillary Mucinous Neoplasms in a Multicenter Surveillance Cohort. 2018

Gausman, Valerie / Kandel, Pujan / Van Riet, Priscilla A / Moris, Maria / Kayal, Maia / Do, Catherine / Poneros, John M / Sethi, Amrita / Gress, Frank G / Schrope, Beth A / Luk, Lyndon / Hecht, Elizabeth / Jovani, Manol / Bruno, Marco J / Cahen, Djuna L / Wallace, Michael B / Gonda, Tamas A. · ·Pancreas · Pubmed #29521942.

ABSTRACT: OBJECTIVES: Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). METHODS: This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included. We evaluated the relationship of baseline demographics and cyst features to disease progression (size increase, development of worrisome features, or high-grade dysplasia/cancer). RESULTS: After a median of 44 months follow-up, 269 (48%) patients experienced cyst size increase, 68 (12%) developed worrisome features, and 11 (2%) developed high-grade dysplasia/cancer. In multivariable Cox-regression analysis, no baseline characteristics were associated with size increase. An initial cyst size of 2 cm or greater, multifocality, history of prostate cancer, and smoking were the strongest predictors of development of new worrisome features. Univariable analysis found male sex, diabetes, and recent weight loss associated with development of high-grade dysplasia/cancer. CONCLUSIONS: Our study demonstrates that low-risk suspected IPMNs carry a small but clinically relevant risk of disease progression and provides data on baseline characteristics that may help in risk stratification.

3 Article International Intraductal Papillary Mucinous Neoplasms Registry: Long-Term Results Based on the New Guidelines. 2017

Moris, Maria / Raimondo, Massimo / Woodward, Timothy A / Skinner, Verna J / Arcidiacono, Paolo G / Petrone, Maria C / De Angelis, Claudio / Manfrè, Selene / Carrara, Silvia / Jovani, Manol / Fusaroli, Pietro / Wallace, Michael B. ·From the *Department of Gastroenterology and †Clinical Studies Unit, Mayo Clinic, Jacksonville, FL; ‡Department of Gastroenterology, San Raffaele Scientific Institute, Milan; §Department of Gastroenterology, Azienda Universitario-Ospedaliera San Giovanni Battista, Turin; ∥Department of Gastroenterology, Humanitas Research Hospital, Milan; and ¶Department of Gastroenterology, University of Bologna/Hospital of Imola, Italy. ·Pancreas · Pubmed #28099263.

ABSTRACT: OBJECTIVE: The aim of this study was to analyze the outcomes of a long-term intraductal papillary mucinous neoplasm (IPMN) registry and evaluate new guidelines. METHODS: A prospectively maintained IPMN registry involving 6 centers in Europe and the United States was used to collect the data. Patients with more than 1-year follow-up and no malignancy diagnosed within the first 3 months of surveillance were included. RESULTS: From 1999 to 2014, 620 patients were included. The median follow-up time was 3 years. Thirty-seven (6%) patients developed malignancy with a median time from IPMN diagnosis to malignancy of 10.3 months. The 1-, 5-, and 10-year actuarial rates of disease-free survival were 97%, 93%, and 92% respectively. Four hundred thirty-one patients met criteria for low-risk branch duct IPMN consisting of cyst size less than 3 cm, with no solid component or main duct dilation. Eight malignancies were diagnosed in this subgroup, all of them within the first 5 years. From this subcohort, 112 patients had a follow-up time of more than 5 years, and no malignancy was diagnosed. CONCLUSIONS: In IPMN lesions with low-risk features at baseline, the risk of progression to malignancy after the first 5 years of follow-up was minimal. Furthermore, the main cyst characteristics remained unchanged during their surveillance.

4 Article Plectin-1 as a Biomarker of Malignant Progression in Intraductal Papillary Mucinous Neoplasms: A Multicenter Study. 2016

Moris, Maria / Dawson, David W / Jiang, Jennifer / Lewis, Jason / Nassar, Aziza / Takeuchi, Kenneth K / Lay, Anna R / Zhai, Qihui / Donahue, Timothy R / Kelly, Kimberly A / Crawford, Howard C / Wallace, Michael. ·From the *Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL; †Department of Pathology and Laboratory Medicine and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; Departments of ‡Pathology and Laboratory Medicine, and §Cancer Biology, Mayo Clinic, Jacksonville, FL; ∥Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; and ¶Department of Bioengineering, School of Engineering and Applied Sciences, and #Robert M. Berne Cardiovasuclar Research Center, School of Medicine, University of Virginia, Charlottesville, VA. ·Pancreas · Pubmed #27101571.

ABSTRACT: OBJECTIVE: This study aimed to evaluate Plectin-1 expression as a biomarker of malignant risk for intraductal papillary mucinous neoplasms (IPMNs). METHODS: Plectin-1 immunohistochemistry (IHC) was performed retrospectively on surgical (n = 71) and cytological (n = 33) specimens from Mayo Clinic Jacksonville and UCLA Medical Center, including IPMNs with low-grade dysplasia, high-grade dysplasia (HGD), or an associated invasive adenocarcinoma. RESULTS: Plectin-1 expression was increased in invasive adenocarcinoma compared with adjacent in situ IPMN (P = 0.005), as well as the in situ HGD component of IPMNs with invasive cancer compared with HGD of IPMNs without invasive cancer (P = 0.02). Plectin IHC discriminated IPMNs with invasive adenocarcinoma from noninvasive IPMN (area under the curve [AUC] of 0.79, 75% sensitivity, and 85% specificity) but was insufficient for discriminating HGD IPMN from low-grade dysplasia IPMNs in surgical resections (AUC of 0.67, 56% sensitivity, and 64% specificity) or fine-needle aspiration specimens (AUC of 0.45). CONCLUSIONS: Although Plectin-1 IHC has insufficient accuracy to be used as a definitive biomarker for malignant risk in the evaluation of IPMN biopsy or cytological specimens, increased Plectin-1 expression observed in both invasive cancer and in situ HGD of malignant IPMNs suggests that it might be successfully leveraged as a cyst fluid biomarker or molecular imaging target.

5 Article Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology, Carcinoembryonic Antigen, and Amylase in Intraductal Papillary Mucinous Neoplasm. 2016

Moris, Maria / Raimondo, Massimo / Woodward, Timothy A / Skinner, Verna / Arcidiacono, Paolo G / Petrone, Maria C / De Angelis, Claudio / Manfrè, Selene / Fusaroli, Pietro / Asbun, Horacio / Stauffer, John / Wallace, Michael B. ·From the *Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL; †Programa de Doctorat en Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; ‡San Raffaele Scientific Institute, Milano, Italy; §Azienda Universitario-Ospedaliera San Giovanni Battista, Torino, Italy; ∥University of Bologna/Hospital of Imola, Imola, Italy; and ¶Department of Surgery, Mayo Clinic, Jacksonville, FL. ·Pancreas · Pubmed #26646270.

ABSTRACT: OBJECTIVES: The aim of this study was to determine the accuracy of cytology, carcinoembryonic antigen (CEA), and amylase levels in the preoperative diagnosis of intraductal papillary mucinous neoplasms (IPMNs). METHODS: An international registry was started in 2005 and included patients with clinically suspected IPMNs. Those who underwent surgery and had preoperative endoscopic ultrasonography fine-needle aspiration were selected for the study. RESULTS: One hundred eighty patients were included. Cytological analysis for neoplastic cells in IPMNs showed high specificity (87.8%) but low sensitivity (39.4%). The median CEA level was 525.5 ng/mL (n = 78) in IPMNs versus 9.7 ng/mL in nonmucinous cysts (n = 6), showing an area under the receiver operating characteristic curve (AUC) of 0.87. The optimal cutoff CEA value for distinguishing IPMN from nonmucinous cysts was 129 ng/mL. At this level, the sensitivity was 76.9%, and specificity was 83.3%, yielding a positive predictive value of 95.9% and a negative predictive value of 41.9%. Carcinoembryonic antigen was a poor predictor of neoplasia in IPMNs (AUC = 0.55). Amylase did not distinguish IPMNs from mucinous cystadenomas (MCAs) (median, 3759 U/L [n = 28 IPMNs] and 497 U/L [n = 3 MCAs], AUC = 0.65). CONCLUSIONS: Cytology has a limited role because of its lack of sensitivity. Carcinoembryonic antigen modestly differentiated between mucinous and nonmucinous lesions. Amylase did not distinguish IPMNs versus MCAs.

6 Article Risk factors for malignant progression of intraductal papillary mucinous neoplasms. 2015

Moris, Maria / Raimondo, Massimo / Woodward, Timothy A / Skinner, Verna / Arcidiacono, Paolo G / Petrone, Maria C / De Angelis, Claudio / Manfrè, Selene / Fusaroli, Pietro / Wallace, Michael B. ·Mayo Clinic, Jacksonville, FL, USA; Programa de Doctorat en Medicina de la Universitat Autònoma de Barcelona, Barcelona, Spain. · Mayo Clinic, Jacksonville, FL, USA. · San Raffaele Scientific Institute, Milano, Italy. · Azienda Universitario-Ospedaliera San Giovanni Battista, Torino, Italy. · University of Bologna/Hospital of Imola, Imola, Italy. · Mayo Clinic, Jacksonville, FL, USA. Electronic address: Wallace.michael@mayo.edu. ·Dig Liver Dis · Pubmed #25869552.

ABSTRACT: BACKGROUND: Intraductal papillary mucinous neoplasms of the pancreas are increasingly diagnosed. Due to their malignant potential, greater understanding of their nature is required. AIMS: Define risk factors for malignancy in intraductal papillary mucinous neoplasms. METHODS: An international, multicentre study was performed in Europe and the United States. Clinical databases were reviewed for patients with intraductal papillary mucinous neoplasms diagnosis. RESULTS: Of 1126 patients, 84 were diagnosed with invasive carcinoma/high-grade dysplasia and were compared to the rest of the cohort. Multivariate logistic analysis showed a statistically significant association between cancer/high-grade dysplasia and the variables smoking history (OR 1.9, 95% CI [1.1-3.1]), body mass index (OR 1.1, 95% CI [1-1.1]), symptoms (OR 3.4, 95% CI [1.9-6]), jaundice (OR 0.1, 95% CI [0-0.3]), and steatorrhea (OR 0.3, 95% CI [0.1-0.8]). Univariate analysis showed no association between malignancy and the cyst number/location (p=0.3 and p=0.5, respectively) although a strong association was shown for cyst size (p<0.001). The presence and size of nodules (p<0.01) and main duct involvement (p<0.001) were also strongly related with malignancy. CONCLUSION: The presence of jaundice and steatorrhea, smoking, high body mass index, and imaging features such as cyst size, main duct involvement, and the presence and size of mural nodules are associated with high-grade neoplasia in intraductal papillary mucinous neoplasms.

7 Article Prevalence and outcomes of cystic lesion of the pancreas in immunosuppressed patients with solid organ transplantation. 2015

Ngamruengphong, Saowanee / Seeger, Kristina M / McCrone, Luke M / Moris, Maria / Garrison, Stephen J / Pungpapong, Surakit / Keaveny, Andrew P / Raimondo, Massimo. ·Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States. · Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, United States. · Department of Radiology, Mayo Clinic, Jacksonville, FL, United States. · Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States; Department of Transplant, Mayo Clinic, Jacksonville, FL, United States. · Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States. Electronic address: raimondo.massimo@mayo.edu. ·Dig Liver Dis · Pubmed #25804443.

ABSTRACT: BACKGROUND: Solid organ transplant recipients have an increased risk of cancer due to immunosuppressive therapy. Pancreatic cystic lesions are increasingly being detected, some with malignant potential. We aimed to determine the prevalence of these lesions and describe their clinical course in these patients. METHODS: We identified the presence of pancreatic cystic lesions in a retrospective cohort of 3188 consecutive solid organ transplant recipients from 2000 to 2013 and compared lesion characteristics at initial and follow-up imaging, when available. RESULTS: Lesion prevalence was 11.4% (365/3188), and increased with age. Median diameter of the largest lesions was 7mm (range: 1-31mm). We noted worrisome features in two patients (0.54%) at the time of cyst diagnosis. Of 155 patients who underwent follow-up imaging, the cysts size remained stable in 80%, increased in 16%, and decreased in 4%. Two patients (1.3%) developed features concerning for cancer. One underwent pancreatic surgery, and pathology confirmed the presence of high-grade dysplasia. The other continued with conservative management due to multiple comorbidities. CONCLUSIONS: Pancreatic cystic lesions are common in solid organ transplant recipients. In lesions without high-risk features, the development of features worrisome for cancer is rare. These lesions can be managed conservatively, and their presence should not affect transplant eligibility.