Management of Pancreatic Intraductal Papillary Mucinous Neoplasm in an Academic Hospital (2005–2010)

Abstract

In the analyzed series, fewer patients than expected underwent surgical resection, and only 67.2% undergo regular follow-up, but no more than 2.4% developed malignancy.

Meta-analysis of mortality in patients with high-risk intraductal papillary mucinous neoplasms under observation

“…The 15 studies included in the qualitative analysis are listed in Table . All but one of these studies were retrospective; six analysed Western populations (Europe and USA), whereas nine were conducted in Asia.…”

“…All but one of these studies were retrospective; six analysed Western populations (Europe and USA), whereas nine were conducted in Asia. Worrisome features and high‐risk stigmata considered in each study were heterogeneous, as some studies included only IPMNs with involvement of the main pancreatic duct, whereas others focused on branch‐duct IPMNs with worrisome features; few studies evaluated all consecutive non‐operated patients with indications for surgery according to ICG‐I or ICG‐II.…”

“…The term ‘physicians’ recommendation' included patients in whom surgery was not advocated owing to the presence of borderline criteria for resection (for example cysts of 30 mm or larger, which can initially be kept under observation according to current guidelines, borderline dilatation of main pancreatic duct of 5–6 mm) or because the likelihood of malignancy was deemed to be low for any other reason. A follow‐up interval for the subgroup of interest was not provided in four studies; the others reported follow‐up ranging from 24·9 to 70 months. Several studies did not report follow‐up modalities, and in the others these were heterogeneous in terms of intervals and procedures.…”

“…Data on disease progression were reported in only nine of 15 studies, with heterogeneous definitions, and disease progression was observed in 257 of 580 patients (44·3 (range 30–52) per cent).…”

Progression of Incidental Intraductal Papillary Mucinous Neoplasms of the Pancreas in Liver Transplant Recipients

“…The prevalence of IPMN in LT patients compared with the general population was 6.6% versus 4.73%. 20 Baseline demographics between our 2 cohorts differed regarding age, sex, and history of smoking and diabetes. Liver transplant patients were likely younger at cyst diagnosis because the majority of LT recipients are between 40 and 60 years old, 21 so they underwent index imaging at that age.…”