Survival After Pancreatic Resection for Intraductal Papillary Mucinous Neoplasm: Supporting Selective Surgery.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Holmberg Marcus, Dall'Olio Tomaso, Marwa Mohamed, Hansen Carsten Palnaes, Kleive Dyre Berg, Nappo Gennaro, Shi Lam, Sandström Per, Björk Dennis, Hadesi Parsa, De Rosa Raffaele Vincenzo, Andersson Bodil, Ansari Daniel, Chikkala Bhargava, Todeschini Letizia, Leseman Charlotte, Schuitema Job, Lodewijks Yentl, Månsson Christopher, Delis Spiros, Berrevoet Frederik, Giannone Fabio, Xenaki Sofia, Pando Elizabeth, Bertrand Claude, Vasileiadis Konstantinos, Kirchweger Patrick, Ciulla Calogero, Luchini Claudio, Luyer Misha, Besselink Marc G, Marchegiani Giovanni, Pandanaboyana Sanjay, Tingstedt Bobby, Sulpice Laurent, Wennerblom Johanna, Björnsson Bergthor, Balakrishnan Anita, Labori Knut Jørgen, Burgdorf Stefan Kobbelgaard, Qadan Motaz, Sparrelid Ernesto, Pea Antonio, Hernandez-Barco Yasmin G, Salvia Roberto, Ghorbani Poya
Аннотация
METHODS: Adult patients with resected IPMN showing LGD, high grade dysplasia (HGD) or T1-staged invasive carcinoma from 2008-2023 were identified from the OPTIMAL-IPMN database. Estimated OS rates at one, five and 10 years in patients undergoing preventive pancreatic resection were assessed using Kaplan-Meier analyses and predictors for mortality were evaluated using parametric survival regressions.
RESULTS: Among 2275 patients in the OPTIMAL-IPMN database, 1728 (77%) had undergone preventive pancreatic resection for IPMN. Of those were 61% resected without prior surveillance. Final pathology revealed LGD in 63%, HGD in 27% and T1a-c-staged invasive cancer in 10% (7.3% T1a-b, 2.8% T1c). Estimated 1-year OS rate was 97%. Estimated 5-year OS rates (landmark analysis at 1 year) for LGD, HGD, T1a-b, and T1c was 97%, 99%, 96% and 91% respectively. Independent predictors for long-term mortality included age ≥ 75 versus < 75 years (HR 1.97) and T1c versus LGD (HR 8.12).
CONCLUSION: This multinational study confirms excellent survival after preventive IPMN resection but reveals many upfront resections yielding LGD with unknown survival benefit. Future studies should aim to determine which patients can be followed safely with monitoring to avoid unnecessary immediate resection.