Survival Analysis and Risk for Progression of Intraductal Papillary Mucinous Neoplasia of the Pancreas IPMN Under Surveillance: A Single-Institution ExperienceReportar como inadecuado




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Annals of Surgical Oncology

, Volume 24, Issue 4, pp 1120–1126

First Online: 07 November 2016Received: 12 August 2016DOI: 10.1245-s10434-016-5661-x

Cite this article as: Del Chiaro, M., Ateeb, Z., Hansson, M.R. et al. Ann Surg Oncol 2017 24: 1120. doi:10.1245-s10434-016-5661-x

Abstract

PurposeWhile surveillance of the majority of patients with IPMN is considered best practice, consensus regarding the duration of follow-up is lacking. This study assessed the survival rate and risk for progression of IPMN under surveillance.

MethodsAll patients diagnosed with and surveyed for IPMN between January 2008 and December 2013 were identified and assigned to two groups: patients without indication for surgery Group 1, and patients whose IPMN required surgery but were inoperable for general reasons Group 2. Disease progression and survival data were compared between both groups.

ResultsIn total 503 patients were identified, of whom 444 88.3% were followed up. Group 1 included 395 patients, and Group 2 had 49. In Group 1, IPMN-specific 1-, 5-, and 10-year survival rates were 100, 100, and 94.2%, respectively. Four patients died of associated or concomitant pancreatic cancer, and 230 patients 58.2% experienced disease progression. The 1-, 4-, 10-year cumulative risk for progression and for surgery was 11.2, 70.6, 97.5, and 2.9, 26.2, 72.1%, respectively. In Group 2, the 1-, 5-, 10-year IPMN-specific survival rate was 90.7, 74.8, and 74.8%, respectively.

ConclusionsThis study confirmed the safety of surveillance for patients with IPMN who do not require surgery. However, the risk for disease progression and for surgery increases significantly over time. The study results support International and European guidelines not to discontinue IPMN surveillance and validate the European recommendation to intensify follow-up after 5 years. The fairly good prognosis of patients whose IPMN requires surgery but cannot undergo resection suggests a relatively indolent disease biology.

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Autor: Marco Del Chiaro - Zeeshan Ateeb - Marcus Reuterwall Hansson - Elena Rangelova - Ralf Segersvärd - Nikolaos Kartalis - Chr

Fuente: https://link.springer.com/







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