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Natural history of intraductal papillary mucinous neoplasm and non‐neoplastic cyst: long‐term imaging follow‐up study
Author(s) -
Hisada Yuya,
Nagata Naoyoshi,
Imbe Koh,
Takasaki Yusuke,
Sekine Katsunori,
Tajima Tsuyoshi,
Yanase Mikio,
Fujimoto Kazuma,
Akiyama Junichi,
Uemura Naomi
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.463
Subject(s) - medicine , cyst , incidence (geometry) , standardized mortality ratio , intraductal papillary mucinous neoplasm , hazard ratio , magnetic resonance imaging , neoplastic transformation , population , radiology , pancreas , gastroenterology , cancer , pathology , confidence interval , carcinogenesis , physics , environmental health , optics
Abstract Background To identify differences in incidence and mortality of pancreatic cancer (PC) between intraductal papillary mucinous neoplasm (IPMN) and non‐neoplastic cyst. Methods Patients with pancreatic cyst ( n = 526; 263 with IPMN and 263 with non‐neoplastic cyst matched for age, sex, and diagnosis year) were periodically followed‐up with imaging. Hazard ratio (HR), standardized incidence ratio (SIR), and standardized mortality ratio (SMR) for PC and PC‐related mortality were estimated. Results During a mean follow‐up of 57.5 months with 3,376 computed tomography scans and 1,079 magnetic resonance imaging scans, 5‐year cumulative PC incidence was 4.0% for IPMN and 0% for non‐neoplastic cyst, respectively (HR 5.2; P = 0.031). During a mean follow‐up of 73.1 months, 5‐year cumulative PC‐related mortality was 2.6% for IPMN and 0% for non‐neoplastic cyst, respectively (HR 4.5; P = 0.05). Compared with the general population in Japan, patients with IPMN, but not those with non‐neoplastic cyst, had significantly increased risks of PC incidence (SIR 22.03) and related mortality (SMR 15.9). Conclusions During long‐term imaging follow‐up, patients with IPMN developed PC over time, whereas none of the patients with non‐neoplastic cyst developed it within 5 years. Compared with the general population, patients with IPMN, but not those with non‐neoplastic cyst, were at risk of PC and related mortality.