The role of age in pancreatic intraductal papillary mucinous neoplasms of the pancreas: Same risk of death but different implications for management.
Dig Liver Dis
; 50(12): 1327-1333, 2018 12.
Article
in En
| MEDLINE
| ID: mdl-29941281
ABSTRACT
BACKGROUND:
Current guidelines do not address the role of age in the management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.AIM:
To evaluate whether clinical features and risk for malignancy are affected by patient's age at diagnosis.METHODS:
In total, 2189 IPMNs, both surgically resected or surveilled, were dichotomized according to a 50-year-old cutoff and compared in terms of pathological features, cumulative risk of developing high-risk stigmata (HRS), overall survival (OS) and disease-specific survival (DSS).RESULTS:
Patients <50 years had more frequent abdominal pain (38.5 vs. 22.4%; pâ¯<â¯0.01) and acute pancreatitis (20.4 vs. 9.3%; pâ¯<â¯0.01) at presentation. Patients ≥50 years old had more multifocal IPMNs (50 vs. 36.9%; pâ¯<â¯0.01), HRS (8.5% vs. 4.3%; pâ¯=â¯0.04) and invasive IPMNs (26.6% vs. 17.3%; pâ¯=â¯0.03) when resected. Moreover, patients ≥50 years old had a significantly higher cumulative risk of developing HRS over time, and a significantly lower OS, but similar DSS when compared with those <50 years old.CONCLUSIONS:
IPMNs diagnosed in older patients are more likely to progress to HRS despite the fact that cancer-related death is not affected by age. The follow-up schedule should not be adjusted according to age, but one should take into account that IPMNs in younger individuals have more time to progress toward malignancy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreas
/
Pancreatic Intraductal Neoplasms
Type of study:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Dig Liver Dis
Journal subject:
GASTROENTEROLOGIA
Year:
2018
Document type:
Article
Affiliation country:
Italy