Survival After Pancreatic Resection for Intraductal Papillary Mucinous Neoplasm: Supporting Selective Surgery
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Resection of intraductal papillary mucinous neoplasm (IPMN) aims to prevent progression to invasive pancreatic cancer. However, the risks of pancreatic surgery and frequent findings of low-grade dysplasia (LGD) raise concerns about overtreatment. This EAHPBA-endorsed multinational study evaluated short- and long-term overall survival (OS) following preventive resection for IPMN (without pre-operative signs of cancer). 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.
DOI: 10.1002/ueg2.70199
Authors: Marcus Holmberg, Tomaso Dall'Olio, Mohamed Marwa, Carsten Palnaes Hansen, Dyre Berg Kleive, Gennaro Nappo, Lam Shi, Per Sandström, Dennis Björk, Parsa Hadesi, Raffaele Vincenzo De Rosa, Bodil Andersson, Daniel Ansari, Bhargava Chikkala, Letizia Todeschini, Charlotte Leseman, Job Schuitema, Yentl Lodewijks, Christopher Månsson, Spiros Delis, Frederik Berrevoet, Fabio Giannone, Sofia Xenaki, Elizabeth Pando, Claude Bertrand, Konstantinos Vasileiadis, Patrick Kirchweger, Calogero Ciulla, Claudio Luchini, Misha Luyer, Marc G. Besselink, Giovanni Marchegiani, Sanjay Pandanaboyana, Bobby Tingstedt, Laurent Sulpice, Johanna Wennerblom, Bergthor Björnsson, Anita Balakrishnan, Knut Jørgen Labori, Stefan Kobbelgaard Burgdorf, Motaz Qadan, Ernesto Sparrelid, Antonio Pea, Yasmin G. Hernandez‐Barco, Roberto Salvia, Poya Ghorbani
Institutions: Karolinska Institutet, Saint Göran Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Massachusetts General Hospital, Copenhagen University Hospital, Rigshospitalet, Oslo University Hospital, University of Oslo, Humanitas University, Addenbrooke's Hospital, Linköping University, Sahlgrenska University Hospital, Region Västra Götaland, University of Gothenburg, Centre Hospitalier Universitaire de Rennes, Lund University, Skåne University Hospital, Freeman Hospital, University of Padua, Amsterdam UMC Location University of Amsterdam, Cancer Center Amsterdam, University of Amsterdam, Catharina Ziekenhuis, Uppsala University, Ghent University Hospital, Hôpitaux Universitaires de Strasbourg, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital Universitari, Papageorgiou General Hospital, Karolinska University Hospital
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,930
OpenAlex ID: W7140223239