Natural history of intraductal papillary mucinous neoplasm and non-neoplastic cyst: long-term imaging follow-up study

J Hepatobiliary Pancreat Sci. 2017 Jul;24(7):401-408. doi: 10.1002/jhbp.463. Epub 2017 Jun 19.

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.

Keywords: Cohort analysis; Magnetic resonance imaging; Multidetector computed tomography; Pancreatic cancer; Pancreatic cyst.

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / mortality
  • Aged
  • Aged, 80 and over
  • Carcinoma, Pancreatic Ductal / diagnostic imaging*
  • Carcinoma, Pancreatic Ductal / mortality
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Japan / epidemiology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pancreatic Cyst / diagnostic imaging*
  • Pancreatic Cyst / epidemiology
  • Pancreatic Cyst / mortality
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / mortality
  • Retrospective Studies
  • Tomography, X-Ray Computed