The DOI matches its Crossref record; 65 of the 65 references it cites were found in a registry or an index.
Long-term Risk of Malignancy in Branch-Duct Intraductal Papillary Mucinous Neoplasms
Abstract
BACKGROUND & AIMS Long-term outcomes of patients with branch-duct intraductal papillary mucinous neoplasms (IPMNs), particularly those after 5 years if surveillance, have not been fully evaluated in large studies. We analyzed incidences of IPMN-derived carcinoma and concomitant ductal adenocarcinoma (PDAC) over 20 years in a large population of patients. METHODS We identified 1404 consecutive patients (52% female; mean age, 67.5 years) with a diagnosis of branch-duct IPMN, from 1994 through 2017, at the University of Tokyo in Japan. Using a competing-risk analysis, we estimated cumulative incidence of pancreatic carcinoma, overall and by carcinoma type. We used competing-risks proportional hazards models to estimate sub-distribution hazard ratios (SHRs) for incidences of carcinomas. To differentiate IPMN-derived and concomitant carcinomas, we collected genomic DNA from available paired samples of IPMNs and carcinomas and detected mutations in GNAS and KRAS by PCR and pyrosequencing. RESULTS During 9231 person-years of follow up, we identified 68 patients with pancreatic carcinomas (38 patients with IPMN-derived carcinomas and 30 patients with concomitant PDACs); the overall incidence rates were 3.3%, 6.6%, and 15% at 5, 10, and 15 years, respectively. Among 804 patients followed more than 5 years, overall cumulative incidence rates of pancreatic carcinoma were 3.5% at 10 years and 12% at 15 years from the initial diagnosis. The size of the IPMN and the diameter of the main pancreatic duct associated with incidence of IPMN-derived carcinoma (SHR, 1.85; 95% CI, 1.38-2.48 for a 10-mm increase in the IPMN size and SHR, 1.56; 95% CI, 1.33-1.83 for a 1-mm increase in the main pancreatic duct diameter) but not with incidence of concomitant PDAC CONCLUSIONS: In a large long-term study of patients with branch-duct IPMNs, we found the 5-year incidence rate of pancreatic malignancy to be 3.3%, reaching 15% at 15 years after IPMN diagnosis. We observed heterogeneous risk factor profiles between IPMN-derived and concomitant carcinomas.
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Metadata
- Authors
- Oyama, H., Tada, M., Takagi, K., Tateishi, K., Hamada, T., Nakai, Y., Hakuta, R., Ijichi, H., Ishigaki, K., Kanai, S., Kogure, H., Mizuno, S., Saito, K., Saito, T., Sato, T., Suzuki, T., Takahara, N., Morishita, Y., Arita, J., Hasegawa, K., Tanaka, M., Fukayama, M., & Koike, K.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2020-01
- Volume
- 158
- Issue
- 1
- Pages
- 226-237.e5
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2971323772
- Cited by
- 316
- References
- 65
- FWCI
- 10.34
- Type
- journal article
- Language
- en
- Open access
- closed
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- Oyama, H., Tada, M., Takagi, K., Tateishi, K., Hamada, T., Nakai, Y., Hakuta, R., Ijichi, H., Ishigaki, K., Kanai, S., Kogure, H., Mizuno, S., Saito, K., Saito, T., Sato, T., Suzuki, T., Takahara, N., Morishita, Y., Arita, J., . . . Koike, K. (2020). Long-term Risk of Malignancy in Branch-Duct Intraductal Papillary Mucinous Neoplasms. Gastroenterology. https://doi.org/10.1053/j.gastro.2019.08.032
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