Is Surveillance Warranted for Presumed Branch-Duct IPMNs Diagnosed at Age 75 or Older? A Single-Center Retrospective Cohort Study.

IF 4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
José Lariño Noia, Yessica Domínguez Novoa, Mónica Otero Iglesias, Martiño Loureiro Veira, Marco Galego Fernández, Alberto Rama Fernández, Daniel de la Iglesia, Julio Iglesias García, Enrique Domínguez Muñoz
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Abstract

Introduction: Incidental cystic pancreatic lesions are increasingly detected in the aging population, with branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) being the most common. This study aimed to evaluate the benefits of implementing a surveillance program in patients diagnosed with presumed BD-IPMN at the age of 75 years or older.

Methods: A retrospective analysis was conducted using a prospective registry of patients diagnosed incidentally with presumed BD-IPMN at ≥75 years of age. Patients were categorized into two groups: Group A, who underwent clinical and imaging follow-up, and Group B, with no surveillance. Clinical records were reviewed to assess pancreatic cancer incidence, overall survival, and mortality.

Results: Among 434 patients with BD-IPMN, 93 met inclusion criteria (42 in Group A; 51 in Group B). The mean age was 77 years in Group A and 79.2 years in Group B (p=0.016). The mean cyst size was 15.6 mm in Group A and 14.6 mm in Group B (p=0.56). No cases of pancreatic cancer were identified in Group A, while one case occurred in Group B (p=1.0). Five patients died in each group (p=1.0). Overall survival was comparable between groups (HR 0.8; 95% CI: 0.22-2.94; p=0.74).

Conclusions: Presumed incidental BD-IPMNs diagnosed at ≥75 years of age rarely progress to pancreatic cancer. In patients with cysts <2 cm and without high-risk features, surveillance does not appear to confer a survival benefit and may therefore be unnecessary.

75岁或以上诊断为支管IPMNs的患者是否有必要进行监测?单中心回顾性队列研究。
在老年人群中,偶发性囊性胰腺病变越来越多地被发现,其中以支管导管内乳头状粘液瘤(BD-IPMNs)最为常见。本研究旨在评估在75岁或以上诊断为BD-IPMN的患者中实施监测计划的益处。方法:对年龄≥75岁的偶然诊断为BD-IPMN的患者进行前瞻性登记进行回顾性分析。患者分为两组:A组接受临床和影像学随访,B组不进行监测。我们回顾了临床记录,以评估胰腺癌的发病率、总生存率和死亡率。结果:434例BD-IPMN患者中,93例符合纳入标准(A组42例,B组51例)。A组平均年龄77岁,B组平均年龄79.2岁(p=0.016)。A组平均囊肿大小为15.6 mm, B组平均囊肿大小为14.6 mm (p=0.56)。A组无胰腺癌病例,B组1例(p=1.0)。两组患者死亡5例(p=1.0)。两组间总生存率比较(HR 0.8; 95% CI: 0.22-2.94; p=0.74)。结论:≥75岁时诊断的推测为偶发的BD-IPMNs很少进展为胰腺癌。对于囊肿患者
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来源期刊
CiteScore
2.00
自引率
25.00%
发文量
400
审稿时长
6-12 weeks
期刊介绍: La Revista Española de Enfermedades Digestivas, Órgano Oficial de la Sociedad Española de Patología Digestiva (SEPD), Sociedad Española de Endoscopia Digestiva (SEED) y Asociación Española de Ecografía Digestiva (AEED), publica artículos originales, editoriales, revisiones, casos clínicos, cartas al director, imágenes en patología digestiva, y otros artículos especiales sobre todos los aspectos relativos a las enfermedades digestivas.
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