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ID 62841
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Yamazaki, Tatsuhiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Tomoda, Takeshi Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID
Kato, Hironari Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap
Miyamoto, Kazuya Department of Gastroenterology and Hepatology, Okayama University Hospital
Matsumi, Akihiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Ueta, Eijiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Fujii, Yuki Department of Gastroenterology and Hepatology, Okayama University Hospital
Saragai, Yosuke Department of Gastroenterology and Hepatology, Okayama University Hospital
Uchida, Daisuke Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap
Matsumoto, Kazuyuki Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID publons
Horiguchi, Shigeru Department of Gastroenterology and Hepatology, Okayama University Hospital
Tsutsumi, Koichiro Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital Kaken ID publons researchmap
Abstract
Objective Strict follow-up is recommended for branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) to avoid missing the development of high-risk stigmata (HRS) at a premalignant stage. This study explored the risk factors associated with the development of HRS during follow-up. Methods We performed a retrospective analysis of 283 patients with BD-IPMN, treated at Okayama University Hospital in Japan between January 2009 and December 2016. Only patients with imaging studies indicative of classical features of BD-IPMN without HRS and followed for over one year were included in the study. We performed radiological follow-up every six months and collected patients' demographic data, cyst characteristics, and clinical outcomes and used univariate logistic regression models to determine the odds of developing HRS. Results Ten patients (3.5%) developed HRS after a median surveillance period of 55.8 months. The main pancreatic duct (MPD) size (5-9 mm) and cyst growth rate (>2.5 mm/year) were both suggested to be possible risk factors for the development of HRS [odds ratio, 14.2; 95% confidence interval (CI), 3.1-65.2, p=0.0006, and odds ratio, 6.1; 95% CI 1.5-25.5, p=0.014]. Regarding the number of worrisome features (WFs), the rate of HRS development was 2.0% (4/199) in cases with no WF, 1.6% (1/62) in cases with single WF and 22.7% (5/22) in cases with multiple WFs, respectively. The rate of HRS development was significantly higher in cases with multiple WFs than in the other cases (p<0.0001). Conclusion MPD dilation, rapid cyst growth, and multiple WFs were significant risk factors for the development of HRS. In the presence of such features, it is necessary to closely follow the development of HRS and avoid missing the best opportunity to perform surgical intervention.
Keywords
surveillance
prognosis factor
intraductal papillary mucinous neoplasm
pancreatic cancer
Published Date
2021-10-15
Publication Title
Internal Medicine
Volume
volume60
Issue
issue20
Publisher
The Japanese Society of Internal Medicine
Start Page
3205
End Page
3211
ISSN
0918-2918
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2021 The Japanese Society of Internal Medicine
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isVersionOf https://doi.org/10.2169/internalmedicine.7168-21
License
https://creativecommons.org/licenses/by-nc-nd/4.0/