Risk of pancreatic malignancy and mortality in branch-duct IPMNs undergoing surveillance: A systematic review and meta-analysis
作者： Stefano Crippa , Gabriele Capurso , Calogero Cammà , Gianfranco Delle Fave , Carlos Fernández-del Castillo
DOI: 10.1016/J.DLD.2016.02.003
关键词: Carcinoma 、 Mortality rate 、 Watchful waiting 、 Pancreatectomy 、 Meta-analysis 、 Pancreatic cancer 、 Oncology 、 Malignant transformation 、 Medicine 、 Pancreatic malignancy 、 Internal medicine 、 Gastroenterology
摘要: Abstract Background Safety of non-operative management for low-risk branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) is debated. Aim To perform a systematic review/meta-analysis to determine their risk developing pancreatic malignancy and malignancy-related deaths. Methods A MEDLINE search was performed methodology based on PRISMA statement. Incidence rates overall malignancy, malignant BD-IPMN, IPMN-distinct PDAC, death were calculated by dividing the total number events person-years (pyrs) follow-up. Heterogeneity determined I2 statistic. Results 20 studies including 2177 patients included. Mean follow-up ranged from 29.3 76.7 months. Overall, 82 (3.7%) developed with pooled estimate rate 0.007/pyrs (I2 = 32.8%). The IPMN 0.004/pyrs (I2 = 40.8%), distinct PDAC 0.002/pyrs (I2 = 0%). due during 0.9%, an Conclusion Non-operative BD-IPMN safe, very low transformation PDAC. mortality low, particularly when compared surgery.
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