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Intraductal Papillary Mucinous Neoplasm Surveillance Leads to Early Diagnosis and Better Outcomes of Concomitant Cancer.
Oyama, Hiroki; Hamada, Tsuyoshi; Nakai, Yousuke; Tanaka, Mariko; Takagi, Kaoru; Fukuda, Rintaro; Hakuta, Ryunosuke; Ishigaki, Kazunaga; Kanai, Sachiko; Kawaguchi, Yoshikuni; Kurihara, Kohei; Nishio, Hiroto; Noguchi, Kensaku; Saito, Tomotaka; Sato, Tatsuya; Suzuki, Tatsunori; Suzuki, Yukari; Takaoka, Shinya; Tange, Shuichi; Takahara, Naminatsu; Hasegawa, Kiyoshi; Ushiku, Tetsuo; Fujishiro, Mitsuhiro.
Afiliación
  • Oyama H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hamada T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Nakai Y; Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
  • Tanaka M; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takagi K; Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
  • Fukuda R; Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hakuta R; Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan.
  • Ishigaki K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Kanai S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Kawaguchi Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Kurihara K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Nishio H; Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
  • Noguchi K; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Saito T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Sato T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Suzuki T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Suzuki Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takaoka S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tange S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takahara N; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hasegawa K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Ushiku T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Fujishiro M; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Ann Surg ; 2024 Mar 20.
Article en En | MEDLINE | ID: mdl-38506039
ABSTRACT

OBJECTIVE:

To examine whether long-term surveillance of intraductal papillary mucinous neoplasms (IPMNs) leads to early diagnosis and better clinical outcomes of pancreatic ductal adenocarcinomas (PDACs) developing concomitantly with IPMNs. SUMMARY BACKGROUND DATA Long-term image-based surveillance is recommended for patients with low-risk IPMNs. However, it is unknown whether the surveillance can improve surgical and survival outcomes of patients with concomitant PDACs.

METHODS:

Using a prospective single-institutional cohort of 4,620 patients with pancreatic cysts including 3,638 IPMN patients, we identified 63 patients who developed concomitant PDAC during long-term surveillance. We compared overall survival (OS) of 46 cases with concomitant PDAC to that of 460 matched cases diagnosed with non-IPMN-associated PDAC at the same institution. Multivariable hazard ratios and 95% confidence intervals (CIs) for overall mortality were computed using the Cox regression model with adjustment for potential confounders.

RESULTS:

Concomitant PDACs were identified at an earlier cancer stage compared to non-IPMN-associated PDACs with 67% and 38% cases identified at stage 2 or earlier, respectively (P<0.001) and 57% and 21% cases with R0 resection, respectively (P<0.001). Compared to non-IPMN-associated PDACs, concomitant PDACs were associated with longer OS (P=0.034) with a multivariable hazard ratio of 0.61 (95% CI, 0.39-0.96). The 5-year survival rate of patients with concomitant PDAC was higher compared to patients with non-IPMN-associated PDAC (34% vs. 18%, respectively; P=0.018).

CONCLUSIONS:

The surveillance for patients with IPMNs was associated with early identification of concomitant PDACs and longer survival of patients diagnosed with this malignancy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos