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
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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
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Matsumoto, Kazuyuki
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
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Horiguchi, Shigeru
Department of Gastroenterology and Hepatology, Okayama University Hospital
Tsutsumi, Koichiro
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
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Okada, Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Hospital
Kaken ID
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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.
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Keywords | surveillance
prognosis factor
intraductal papillary mucinous neoplasm
pancreatic cancer
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Published Date | 2021-10-15
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Publication Title |
Internal Medicine
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Volume | volume60
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Issue | issue20
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Publisher | The Japanese Society of Internal Medicine
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Start Page | 3205
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End Page | 3211
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ISSN | 0918-2918
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2021 The Japanese Society of Internal Medicine
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File Version | publisher
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Related Url | isVersionOf https://doi.org/10.2169/internalmedicine.7168-21
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License | https://creativecommons.org/licenses/by-nc-nd/4.0/
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