AI Article Synopsis

  • The study investigated whether long-term monitoring of intraductal papillary mucinous neoplasms (IPMNs) results in earlier detection and improved outcomes for pancreatic ductal adenocarcinomas (PDACs) that develop alongside IPMNs.
  • Out of 4,620 patients with pancreatic cysts, 63 developed PDAC during surveillance, and their overall survival (OS) was compared to 460 patients with non-IPMN-associated PDACs.
  • Results showed that patients with concomitant PDACs were diagnosed at earlier cancer stages and had a significantly longer OS and higher 5-year survival rates compared to those with non-IPMN-associated PDACs.

Article Abstract

Objective: To examine whether long-term surveillance of intraductal papillary mucinous neoplasms (IPMNs) leads to early diagnosis and better clinical outcomes of pancreatic ductal adenocarcinomas (PDACs) developing concomitantly with IPMNs.

Summary Background Data: Long-term image-based surveillance is recommended for patients with low-risk IPMNs. However, it is unknown whether the surveillance can improve surgical and survival outcomes of patients with concomitant PDACs.

Methods: Using a prospective single-institutional cohort of 4,620 patients with pancreatic cysts including 3,638 IPMN patients, we identified 63 patients who developed concomitant PDAC during long-term surveillance. We compared overall survival (OS) of 46 cases with concomitant PDAC to that of 460 matched cases diagnosed with non-IPMN-associated PDAC at the same institution. Multivariable hazard ratios and 95% confidence intervals (CIs) for overall mortality were computed using the Cox regression model with adjustment for potential confounders.

Results: Concomitant PDACs were identified at an earlier cancer stage compared to non-IPMN-associated PDACs with 67% and 38% cases identified at stage 2 or earlier, respectively (P<0.001) and 57% and 21% cases with R0 resection, respectively (P<0.001). Compared to non-IPMN-associated PDACs, concomitant PDACs were associated with longer OS (P=0.034) with a multivariable hazard ratio of 0.61 (95% CI, 0.39-0.96). The 5-year survival rate of patients with concomitant PDAC was higher compared to patients with non-IPMN-associated PDAC (34% vs. 18%, respectively; P=0.018).

Conclusions: The surveillance for patients with IPMNs was associated with early identification of concomitant PDACs and longer survival of patients diagnosed with this malignancy.

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Source
http://dx.doi.org/10.1097/SLA.0000000000006268DOI Listing

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