Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance
Objectives:. Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains controversial, particularly regarding cysts follow-up >5 years. The primary endpoint of this study was to assess the risk of malignant transformation of presumed BD-IPMN during follow-up...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health/LWW
2024-12-01
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| Series: | Journal of Pancreatology |
| Online Access: | http://journals.lww.com/10.1097/JP9.0000000000000162 |
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| author | Marie-Pier Bachand Mohamed-Anas Chennouf Mandy Malick Annie Beaudoin |
| author_facet | Marie-Pier Bachand Mohamed-Anas Chennouf Mandy Malick Annie Beaudoin |
| author_sort | Marie-Pier Bachand |
| collection | DOAJ |
| description | Objectives:. Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains controversial, particularly regarding cysts follow-up >5 years. The primary endpoint of this study was to assess the risk of malignant transformation of presumed BD-IPMN during follow-up and identify clinical and morphological predictors of malignancy.
Methods:. We performed a retrospective analysis of data from all patients with a presumed BD-IPMN diagnosis at the CIUSSS de l’Estrie CHUS, from 2004 to 2018.
Results:. The final database included 380 patients with presumed BD-IPMN with a median follow-up of 43.9 months (interquartile range [IQR] 28.6–73.3 months). Mean age at diagnosis was 65.5 years [27–90], 159 patients (42.8%) were male and 17 patients (4.5%) underwent resection of their lesion during their surveillance period. In our cohort, 132 patients (34.7%) had a follow-up of >5 years. Overall risk of malignancy was 2.1% [0.9%–4.1%]. During follow-up, neoplastic transformation was observed in 2 of 132 patients (1.5%) surveilled >5 years. Malignancy was significantly associated with cyst growth >2.5 mm/y (57.1% vs 5.8%; P < .001) dilated MPD (71.4% vs 4.9%; P < .001), solid component (71.4% vs 1.3%; P < .001), positive cytology (37.5% vs 0.5%; P < .001), development of high-risk stigmatas (87.5% vs 1.9%; P < .001), or worrisome features (87.5% vs 23.9%; P < .001) during follow-up and symptoms of jaundice (25% vs 0.5%; P = .002) and abdominal pain (50% vs 9.4%; P = .005).
Conclusion:. While overall malignancy risk remains low in presumed BD-IPMN, continuous surveillance should be pursued after 5 years in surgically fit individuals, particularly in patients who develop our identified risk factors. |
| format | Article |
| id | doaj-art-00fbe7637e47487f931e30ed7fd11f0f |
| institution | OA Journals |
| issn | 2096-5664 2577-3577 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Journal of Pancreatology |
| spelling | doaj-art-00fbe7637e47487f931e30ed7fd11f0f2025-08-20T02:32:33ZengWolters Kluwer Health/LWWJournal of Pancreatology2096-56642577-35772024-12-017427928410.1097/JP9.0000000000000162202412000-00008Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillanceMarie-Pier Bachand0Mohamed-Anas Chennouf1Mandy Malick2Annie Beaudoin3a Division of Gastroenterology, Centre Hospitalier Universitaire Sherbrooke, Sherbrooke, QC, Canadaa Division of Gastroenterology, Centre Hospitalier Universitaire Sherbrooke, Sherbrooke, QC, Canadab Division of Medicine, University of Sherbrooke, Sherbrooke, QC, Canadaa Division of Gastroenterology, Centre Hospitalier Universitaire Sherbrooke, Sherbrooke, QC, CanadaObjectives:. Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains controversial, particularly regarding cysts follow-up >5 years. The primary endpoint of this study was to assess the risk of malignant transformation of presumed BD-IPMN during follow-up and identify clinical and morphological predictors of malignancy. Methods:. We performed a retrospective analysis of data from all patients with a presumed BD-IPMN diagnosis at the CIUSSS de l’Estrie CHUS, from 2004 to 2018. Results:. The final database included 380 patients with presumed BD-IPMN with a median follow-up of 43.9 months (interquartile range [IQR] 28.6–73.3 months). Mean age at diagnosis was 65.5 years [27–90], 159 patients (42.8%) were male and 17 patients (4.5%) underwent resection of their lesion during their surveillance period. In our cohort, 132 patients (34.7%) had a follow-up of >5 years. Overall risk of malignancy was 2.1% [0.9%–4.1%]. During follow-up, neoplastic transformation was observed in 2 of 132 patients (1.5%) surveilled >5 years. Malignancy was significantly associated with cyst growth >2.5 mm/y (57.1% vs 5.8%; P < .001) dilated MPD (71.4% vs 4.9%; P < .001), solid component (71.4% vs 1.3%; P < .001), positive cytology (37.5% vs 0.5%; P < .001), development of high-risk stigmatas (87.5% vs 1.9%; P < .001), or worrisome features (87.5% vs 23.9%; P < .001) during follow-up and symptoms of jaundice (25% vs 0.5%; P = .002) and abdominal pain (50% vs 9.4%; P = .005). Conclusion:. While overall malignancy risk remains low in presumed BD-IPMN, continuous surveillance should be pursued after 5 years in surgically fit individuals, particularly in patients who develop our identified risk factors.http://journals.lww.com/10.1097/JP9.0000000000000162 |
| spellingShingle | Marie-Pier Bachand Mohamed-Anas Chennouf Mandy Malick Annie Beaudoin Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance Journal of Pancreatology |
| title | Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance |
| title_full | Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance |
| title_fullStr | Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance |
| title_full_unstemmed | Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance |
| title_short | Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance |
| title_sort | branch duct intraductal papillary mucinous neoplasm a retrospective study on neoplastic risk after 5 years of surveillance |
| url | http://journals.lww.com/10.1097/JP9.0000000000000162 |
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