Assessing Follow-Up Duration in Intraductal Papillary Mucinous Neoplasm Patients

BACKGROUND With the continuous advancement of cross-sectional imaging technology, the number of incidentally discovered intraductal papillary mucinous neoplasms (IPMN) of the pancreas has been increasing annually. More IPMN patients are suitable for regular follow-up than for surgical resection. This study aimed to explore the appropriate follow-up intervals for IPMN patients with multiple worrisome features (WFs) and high-risk stigmata (HRS). MATERIAL AND METHODS In this single-center retrospective study, IPMN patients with a follow-up period of more than 6 months up to June 2023 were included, and the intervals between the initial diagnosis and the onset of a newly developed WF/HRS were recorded. RESULTS The median time intervals between the appearance of newly developed WFs/HRS in patients without WFs/HRS and those with ≤2 WFs at initial diagnosis were significantly longer than that in patients with >2 WFs and those with HRS (30.0 months vs 21.0 months vs 7.0 months vs 10.0 months; p<0.001). Among postoperative patients, those with low-grade dysplasia were younger at initial diagnosis than those with high-grade dysplasia and invasive carcinoma (59.8 years old vs 69.4 years old; p=0.027). CONCLUSIONS Patients with cysts ≥30 mm can undergo medical examinations biannually. For IPMN patients with cysts <30 mm and containing >2 WFs or HRS, a follow-up interval of 0.5-1.0 years may be appropriate, and regular follow-up of 1.5-2 years is reliable for patients with cysts <30 mm and ≤2 WFs. Moreover, advanced age may be an important risk factor for malignant progression of IPMN.