Korean J Pancreas Biliary Tract.  2024 Oct;29(4):157-166. 10.15279/kpba.2024.29.4.157.

Clinical Outcomes over Several Years for Suspected Branch-Duct Intrapapillary Mucinous Neoplasms of the Pancreas: A Single Referral Center Experience

• Jeong HT
• Han J

• KMID: 2560379
• DOI: http://doi.org/10.15279/kpba.2024.29.4.157

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.

Keyword

Pancreatic intraductal neoplasms; Pancreatic cysts; Pancreatic cancer; Incidence; Aged; 췌관내유두상점액종양; 췌장 낭종; 췌장암; 발생률; 고령