Consequences of a Surveillance Strategy for Side-Branch IPMNs

Introduction
Surveillance of side-branch intraductal papillary mucinous neoplasms (SB-IPMNs) is crucial for managing pancreatic cysts. This study assesses the long-term outcomes of a structured surveillance strategy.

Key Findings
CR-Progression Rate: Among 1,337 patients, 15.3% experienced clinically relevant progression (CR-progression) over a median follow-up of 6.6 years.
Invasive Cancer Development: Only 1.7% developed invasive cancer, indicating that initial size should not be the sole criterion for surgery.
Survival Rates: Patients with CR-progression who underwent resection showed improved survival rates. However, overall survival was not significantly improved for all patients undergoing resection.

Conclusion
Long-term non-operative surveillance for SB-IPMNs is effective, with a low rate of progression to invasive cancer. Surgery should be reserved for those demonstrating CR-progression. This approach helps avoid unnecessary surgeries and focus on patients at higher risk.

Original Study
https://journals.lww.com/annalsofsurgery/abstract/9900/consequences_of_a_surveillance_strategy_for.912.aspx