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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引用次数: 0
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.
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.