Institutional members access full text with Ovid®

Share this article on:

Incidences of Pancreatic Malignancy and Mortality in Patients With Untreated Branch-Duct Intraductal Papillary Mucinous Neoplasms Undergoing Surveillance: A Systematic Review

Lensing, Rutger J. BSc; Bipat, Shandra PhD

doi: 10.1097/MPA.0000000000000907
Original Articles

Objective The aim of this study was to pool incidences of increased cyst size, malignant branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs), pancreatic malignancy, and pancreatic malignancy-related death during follow-up (FU) of BD-IPMN patients.

Methods Searches were performed from January 2010 to April 2016. All hits were checked on inclusion criteria, and outcomes were extracted. Incidences were pooled. Three subgroups were defined: (1) including only BD-IPMN patients, (2) short-interval FU (maximum 6 months), and (3) long-interval FU (>6 months).

Results Thirty-one articles were enrolled, including 8455 patients (mean age, 66.4 years). Twenty-two studies included subgroup 1; 10 and 6 studies included, respectively, subgroups 2 and 3. Incidence of increased cyst size was 17.4%. In subgroups 1, 2, and 3, incidences were, respectively, 20.0%, 17.2%, and 31.7%. Incidence of malignant BD-IPMN was 2.5. In subgroups 1, 2, and 3, incidences were, respectively, 3.0%, 2.4%, and 3.3%. Incidence of pancreatic malignancy was 2.6%. In subgroups 1, 2, and 3, incidences were, respectively, 2.3%, 1.2%, and 4.0%. Incidence of death was 0.5%. In subgroups 1, 2, and 3, incidences were, respectively, 0.4%, 0.04%, and 0.12%.

Conclusions Although not significant, all incidences on long-interval FU were higher; therefore, short-interval FU seems necessary to find resectable lesions.

Supplemental digital content is available in the text.

From the Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.

Received for publication August 30, 2016; accepted July 10, 2017.

Address correspondence to: Rutger J. Lensing, BSc, Department of Radiology, G1-212, Academic Medical Centre, University of Amsterdam, Meibergdreef 9/1105 AZ, Amsterdam, the Netherlands (e-mail: r.j.lensing@amc.uva.nl).

The authors declare no conflict of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.pancreasjournal.com).

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.