Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms without worrisome or high-risk features.
J Surg Oncol
; 128(7): 1087-1094, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-37530526
ABSTRACT
INTRODUCTION:
Long-term data evaluating clinical outcomes in patients with branch-duct Intraductal papillary mucinous neoplasms (BD-IPMN) without high-risk stigmata (HRS) or worrisome features (WF) remain limited.METHODS:
This observational cohort study included all patients diagnosed with BD-IPMN without HRS or WF between 2003 and 2019 who were enrolled in a prospective surveillance program. Time-to-progression analysis was performed using a cumulative incidence function plot and survival analysis was conducted using Kaplan-Meier.RESULTS:
The median follow-up time for the 267 patient cohort was 44.5 months (interquartile range [IQR] 24.1-72.2). Radiographic cyst growth was observed in 123 (46.1%) patients; 65 (24.3%) patients progressed to WF/HRS. Twenty-six (9.7%) patients were selected for resection during surveillance 21 (80.8%) WF, 4 (15.4%) HRS; 1 (3.9%) transformed to mixed-duct. Of all the patients who underwent resection, 5 (19.2%) had adenocarcinoma, and 1 (3.8%) had carcinoma-in-situ. The probability of any radiographic progression was 21.3% (5-year) and 51.3% (10-year). For the entire cohort, there was 1.1% mortality secondary to pancreatic adenocarcinoma and 8.2% all-cause mortality. The 5-year overall survival rate was 91.5%, and at 10 years, 81.5%.CONCLUSION:
Approximately one in four patients with nonworrisome BD-IPMN have progression to WF/HRS stigmata during surveillance. However, the risk of malignant transformation remains low. Surveillance strategy remains prudent in this patient population.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
/
Adenocarcinoma
/
Neoplasias Císticas, Mucinosas e Serosas
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Carcinoma Ductal Pancreático
/
Neoplasias Intraductais Pancreáticas
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
J Surg Oncol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos