Characterizing Biological Behavior Beyond Morphologic Features: Next-Generation Sequencing Analysis of Large vs Small Pancreatic Cystic Lesions in a Large Multicenter Cohort of Patients

The higher malignant potential of large PCLs may be explained by their greater propensity to harbor HRMs associated with advanced neoplasia. Given the superior diagnostic accuracy of NGS for predicting advanced neoplasia in large IPMNs, we recommend incorporating cyst fluid NGS into the management algorithm for patients with IPMNs greater than or equal to 3 cm.