Clinical Outcomes over Several Years for Suspected Branch-Duct Intrapapillary Mucinous Neoplasms of the Pancreas: A Single Referral Center Experience
10.15279/kpba.2024.29.4.157
- Author:
Han Taek JEONG
1
;
Jimin HAN
Author Information
1. Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
- Publication Type:Original Article
- From:Korean Journal of Pancreas and Biliary Tract
2024;29(4):157-166
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Background:/Aim: This study evaluated the cumulative incidence of pancreatic cancer and worrisome features (WFs) in patients with pancreatic cysts (PCs) clinically considered as branch-duct intrapapillary mucinous neoplasm (BD-IPMN).
Methods:Data from 177 patients followed for BD-IPMN were retrospectively analyzed. Suspected BD-IPMN was defined as PCs with confirmed communication with the main pancreatic duct (MPD) via imaging studies, while presumed BD-IPMN referred to PCs lacking clear MPD communication.
Results:Among the patients, 30.5% were categorized as suspected BD-IPMN. The median age at diagnosis was 64 years, with a median cyst size of 13 mm. At diagnosis, 19 patients (10.7%) exhibited WFs, and none of the patients had high-risk stigmata. Over a follow-up period of 70.5 months, pancreatic cancer developed in three patients, resulting in a cumulative incidence of 4.0% (95% confidence interval [CI], 0.98 to 10.76%) at 96 months. For the 158 patients without initial WFs, the cumulative incidence of WFs was 5.1% (95% CI, 2.37 to 9.28%) at 24 months and 11.2% (95% CI, 6.34 to 17.53%) at 96 months. The development of WFs was lower in the presumed BD-IPMN group (p=0.102) and among patients aged under 75 (p=0.463), though these differences were not statistically significant. Notably, the incidence of WFs plateaued after two years in the elderly cohort.
Conclusions:The cumulative incidence of pancreatic cancer and WFs in patients with low-risk PCs was notably low. Furthermore, discontinuing surveillance may be considered for elderly patients, especially those with no changes within the first two years of observation.
