Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Surveillance Strategy for Intraductal Pancreatic Mucinous Neoplasms: Criteria for Discontinuation,” published in the October 2024 issue of Surgery by McGuigan et al.  

The rising prevalence of intraductal pancreatic mucinous neoplasms (IPMN) and the low association with pancreatic cancer raise questions about the need and cost-effectiveness of surveillance.  

Researchers conducted a retrospective study evaluating the surveillance of patients with IPMN, assessing the risk of pancreatic cancer, and estimating the costs associated with surveillance.  

They analyzed patients with IPMN under surveillance in the West of Scotland (WoS) and collected clinicopathological data. Endpoints included the development of pancreatic cancer and cost estimation of surveillance pathways.  

The results showed 746 patients, 27 (3.62%) underwent resection, 3 (0.402%) developed pancreatic cancer, and 44 (5.90%) exhibited worrisome features or high-risk stigmata after a median surveillance period of 48 (IQR 48) months. Among patients with stable cysts for at least 5 years, the standardized incidence ratio (SIR) was 1.56 (95% CI 0.04-8.71), while those aged 75 years or older had an SIR of 1.71 (95% CI 0.03-3.42). Patients aged 65 years and older with stable cysts smaller than 15 mm or those with stable cysts smaller than 10 mm for at least 5 years had SIRs of 0. The cost of surveillance was £6,330.36 ($8,105.65) patient per resected and £2,032.78 ($2,602.85) per non- resected.  

They concluded that patients with stable IPMNs have a pancreatic cancer risk comparable to that of the general population, suggesting surveillance can be safely discontinued after 5 years, potentially saving £106,211.19 ($136,020.42) annually.  

Source: journals.lww.com/annalsofsurgery/abstract/9900/the_surveillance_strategy_for_intraductal.1117.aspx