AB106. SOH25_AB_355. International, multi-centric, long-term follow-up of resected intraductal papillary mucinous neoplasms: risk factors for recurrence, European follow-up patterns, and evidence to support follow-up guidelines
General Surgery III

AB106. SOH25_AB_355. International, multi-centric, long-term follow-up of resected intraductal papillary mucinous neoplasms: risk factors for recurrence, European follow-up patterns, and evidence to support follow-up guidelines

Aidan O’Dowling1, Tom Gallagher1, Marc Besslink2, Kevin Conlon1, Roberto Salvia3, Alejandro Serablo4

1Department of Surgery, St. Vincent’s University Hospital, Dublin, Ireland; 2Department of Surgery, Academic Medical Centre, Cancer Centre Amsterdam, Amsterdam, The Netherlands; 3Department of Surgery, University of Verona, Verona, Italy; 4Hepatopancreatobiliary Surgical Unit, Miguel Servet University Hospital, Zaragoza, Spain

Background: Intraductal papillary mucinous neoplasms (IPMNs) are initially benign pancreatic cysts with malignant potential. Up to 10% of pancreatic resections are performed for IPMN and they may recur. Several international guidelines support indications for resection, but recommendations for post-operative surveillance are lacking. The aims of this study are to compile post-operative complications and follow-up practices across Europe, and define the risk of recurrence in this population.

Methods: All major European pancreatic centres from the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) were invited to contribute data on resected IPMNs in their institutions between 2010 and 2013 to aim for 10-year follow-up. Histology, surgical outcomes, follow-up practices, and recurrence rates were collated.

Results: Data on 537 resections were recorded, 220 (41.0%) had malignant disease at the time of resection, while 113 (21.0%) had a major post-operative complication. Median follow-up was 66.5 months [interquartile range (IQR), 33.75–87 months] with 121 patients recurring. The most significant risk factors for recurrence included malignant disease, high grade dysplasia, positive surgical margins, and lymph nodes positive for disease (all P<0.0001). Median time to recurrence was 21 months. The majority (82.5%) had imaging follow-up, although modality and timing were heterogeneous; 35.0% computed tomography (CT) alone, 30.2% magnetic resonance imaging (MRI) alone. Those with MRI follow-up had better overall [odds ratio (OR) =0.11; P<0.0001].

Conclusions: This is the first reported pan-European experience of IPMN surgery and follow-up. Follow-up for patients is variable between centres. Patients with both malignant and benign IPMNs resected may progress, in some cases years after their initial surgery. Risk factors identified in this study may be stratified to help inform guidelines for follow-up going forward.

Keywords: Hepatopacreaticobiliary surgery; intraductal papillary mucinous neoplasm (IPMN); pancreatic cancer; recurrence; surveillance

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab106
Cite this abstract as: O’Dowling A, Gallagher T, Besslink M, Conlon K, Salvia R, Serablo A. AB106. SOH25_AB_355. International, multi-centric, long-term follow-up of resected intraductal papillary mucinous neoplasms: risk factors for recurrence, European follow-up patterns, and evidence to support follow-up guidelines. Mesentery Peritoneum 2025;9:AB106.

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