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International Intraductal Papillary Mucinous Neoplasms Registry: Long-Term Results Based on the New Guidelines

Moris, Maria MD*; Raimondo, Massimo MD*; Woodward, Timothy A. MD*; Skinner, Verna J. MS; Arcidiacono, Paolo G. MD; Petrone, Maria C. MD; De Angelis, Claudio MD§; Manfrè, Selene MD§; Carrara, Silvia MD; Jovani, Manol MD; Fusaroli, Pietro MD; Wallace, Michael B. MD, MPH*

doi: 10.1097/MPA.0000000000000750
Original Articles

Objective The aim of this study was to analyze the outcomes of a long-term intraductal papillary mucinous neoplasm (IPMN) registry and evaluate new guidelines.

Methods A prospectively maintained IPMN registry involving 6 centers in Europe and the United States was used to collect the data. Patients with more than 1-year follow-up and no malignancy diagnosed within the first 3 months of surveillance were included.

Results From 1999 to 2014, 620 patients were included. The median follow-up time was 3 years. Thirty-seven (6%) patients developed malignancy with a median time from IPMN diagnosis to malignancy of 10.3 months. The 1-, 5-, and 10-year actuarial rates of disease-free survival were 97%, 93%, and 92% respectively. Four hundred thirty-one patients met criteria for low-risk branch duct IPMN consisting of cyst size less than 3 cm, with no solid component or main duct dilation. Eight malignancies were diagnosed in this subgroup, all of them within the first 5 years. From this subcohort, 112 patients had a follow-up time of more than 5 years, and no malignancy was diagnosed.

Conclusions In IPMN lesions with low-risk features at baseline, the risk of progression to malignancy after the first 5 years of follow-up was minimal. Furthermore, the main cyst characteristics remained unchanged during their surveillance.

Supplemental digital content is available in the text.

From the *Department of Gastroenterology and †Clinical Studies Unit, Mayo Clinic, Jacksonville, FL; ‡Department of Gastroenterology, San Raffaele Scientific Institute, Milan; §Department of Gastroenterology, Azienda Universitario-Ospedaliera San Giovanni Battista, Turin; ∥Department of Gastroenterology, Humanitas Research Hospital, Milan; and ¶Department of Gastroenterology, University of Bologna/Hospital of Imola, Italy.

Received for publication February 2, 2016; accepted September 27, 2016.

Address correspondence to: Michael B. Wallace, MD, MPH, Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 (e-mail:

This study was supported by the Joyce E. Baker Foundation for Research at Mayo Clinic in Florida.

Conflict of interest/disclosures: MBW receives research funding from Olympus, Boston Scientific, and Ninepoint Medical. MBW received consulting fees in 2015 from Olympus and iLumen that are unrelated to this study.

Author contributions: MM and MBW contributed to all aspects of this study and article. MR, TAW, PGA, MCP, CDA, SM, SC, MJ, and PF contributed to study conception and design, experiments, collection of the data, and critical revision of the article. VS contributed to collection of the data and critical revision of the article. All authors approved the final draft of the article.

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