Survival After Pancreatic Resection for Intraductal Papillary Mucinous Neoplasm: Supporting Selective Surgery

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pancreatic Diseases

Background:

• Intraductal papillary mucinous neoplasm (IPMN) resection aims to prevent pancreatic cancer.
• Concerns exist regarding overtreatment due to surgical risks and frequent low-grade dysplasia (LGD) findings.

Purpose of the Study:

• Evaluate short- and long-term overall survival (OS) following preventive resection for IPMN.
• Assess the necessity of upfront resection for all IPMN cases.

Main Methods:

• Multinational study of adult patients with resected IPMN (LGD, HGD, or T1-staged cancer) from 2008-2023.
• Kaplan-Meier analyses for OS rates; parametric survival regressions for mortality predictors.

Main Results:

• 1728 patients underwent preventive resection; 63% had LGD, 27% HGD, 10% T1 cancer.
• Estimated 5-year OS rates ranged from 91% (T1c) to 99% (HGD).
• Age ≥75 and T1c cancer were independent predictors of long-term mortality.

Conclusions:

• Preventive IPMN resection demonstrates excellent survival outcomes.
• Many upfront resections reveal LGD, suggesting potential overtreatment.
• Further research is needed to identify patients suitable for surveillance over immediate resection.