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Gastrointestinal cancer precursor risk and mortality in pancreatic intraductal papillary mucinous neoplasms : a nationwide cohort study

Vujasinovic, Miroslav ; Elbe, Peter ; Ekheden, Isabella ; Wang, Qiao-Li LU orcid ; Thuresson, Marcus ; Roelstraete, Bjorn ; Ghazi, Sam ; Löhr, J-Matthias and Ludvigsson, Jonas F (2024) In Scandinavian Journal of Gastroenterology 59(5). p.600-607
Abstract

BACKGROUND AND AIMS: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a precursor of pancreatic cancer. While earlier research has shown a high prevalence of synchronous/metachronous extrapancreatic tumors in IPMN patients, these studies have often been small with retrospective data collection. The aim of the study was to examine absolute and relative risks of non-pancreatic gastrointestinal (GI) cancer precursors and mortality in histologically confirmed IPMN.

METHODS: Through the nationwide ESPRESSO histopathology cohort, we retrieved data on IPMN between 1965 and 2016. Each index case was matched to ≤5 general population controls. Through Cox regression, we estimated hazard ratios (HRs) for future GI cancer... (More)

BACKGROUND AND AIMS: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a precursor of pancreatic cancer. While earlier research has shown a high prevalence of synchronous/metachronous extrapancreatic tumors in IPMN patients, these studies have often been small with retrospective data collection. The aim of the study was to examine absolute and relative risks of non-pancreatic gastrointestinal (GI) cancer precursors and mortality in histologically confirmed IPMN.

METHODS: Through the nationwide ESPRESSO histopathology cohort, we retrieved data on IPMN between 1965 and 2016. Each index case was matched to ≤5 general population controls. Through Cox regression, we estimated hazard ratios (HRs) for future GI cancer precursors and death.

RESULTS: A total of 117 patients with IPMN and 539 age- and sex-matched controls were included. Over a median of 2.1 years of follow up, we confirmed two (1.7%) incident GI cancer precursors in IPMN vs. four (0.7%) in controls, corresponding to an HR of 1.89 (95%CI = 0.34-10.55). By contrast, IPMN patients were at increased risk of death (HR 3.61 (95%CI = 1.79-7.27)). The most common cause of death in IPMN was pancreatic cancer (n = 14; 45.2% of all deaths).

CONCLUSIONS: We found no association between IPMN and other GI cancer precursors. This argues against comprehensive routine surveillance for other GI cancer precursors in IPMN patients. Mortality was increased in IPMN with pancreatic cancer being the most common cause of death, indicating the need for lifelong follow up in all resected and non-resected patients with IPMN. However, results should be confirmed in larger cohorts.

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author
; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Humans, Female, Male, Aged, Middle Aged, Gastrointestinal Neoplasms/mortality, Pancreatic Neoplasms/mortality, Pancreatic Intraductal Neoplasms/mortality, Retrospective Studies, Case-Control Studies, Proportional Hazards Models, Aged, 80 and over, Adult, Adenocarcinoma, Mucinous/mortality, Risk Factors, Carcinoma, Pancreatic Ductal/mortality
in
Scandinavian Journal of Gastroenterology
volume
59
issue
5
pages
600 - 607
publisher
Informa Healthcare
external identifiers
  • scopus:85185662329
  • pmid:38351653
ISSN
0036-5521
DOI
10.1080/00365521.2024.2310162
language
English
LU publication?
no
id
851b71b5-939d-463d-84bf-38064aaa47cb
date added to LUP
2025-05-12 17:12:06
date last changed
2025-06-10 06:59:12
@article{851b71b5-939d-463d-84bf-38064aaa47cb,
  abstract     = {{<p>BACKGROUND AND AIMS: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a precursor of pancreatic cancer. While earlier research has shown a high prevalence of synchronous/metachronous extrapancreatic tumors in IPMN patients, these studies have often been small with retrospective data collection. The aim of the study was to examine absolute and relative risks of non-pancreatic gastrointestinal (GI) cancer precursors and mortality in histologically confirmed IPMN.</p><p>METHODS: Through the nationwide ESPRESSO histopathology cohort, we retrieved data on IPMN between 1965 and 2016. Each index case was matched to ≤5 general population controls. Through Cox regression, we estimated hazard ratios (HRs) for future GI cancer precursors and death.</p><p>RESULTS: A total of 117 patients with IPMN and 539 age- and sex-matched controls were included. Over a median of 2.1 years of follow up, we confirmed two (1.7%) incident GI cancer precursors in IPMN vs. four (0.7%) in controls, corresponding to an HR of 1.89 (95%CI = 0.34-10.55). By contrast, IPMN patients were at increased risk of death (HR 3.61 (95%CI = 1.79-7.27)). The most common cause of death in IPMN was pancreatic cancer (n = 14; 45.2% of all deaths).</p><p>CONCLUSIONS: We found no association between IPMN and other GI cancer precursors. This argues against comprehensive routine surveillance for other GI cancer precursors in IPMN patients. Mortality was increased in IPMN with pancreatic cancer being the most common cause of death, indicating the need for lifelong follow up in all resected and non-resected patients with IPMN. However, results should be confirmed in larger cohorts.</p>}},
  author       = {{Vujasinovic, Miroslav and Elbe, Peter and Ekheden, Isabella and Wang, Qiao-Li and Thuresson, Marcus and Roelstraete, Bjorn and Ghazi, Sam and Löhr, J-Matthias and Ludvigsson, Jonas F}},
  issn         = {{0036-5521}},
  keywords     = {{Humans; Female; Male; Aged; Middle Aged; Gastrointestinal Neoplasms/mortality; Pancreatic Neoplasms/mortality; Pancreatic Intraductal Neoplasms/mortality; Retrospective Studies; Case-Control Studies; Proportional Hazards Models; Aged, 80 and over; Adult; Adenocarcinoma, Mucinous/mortality; Risk Factors; Carcinoma, Pancreatic Ductal/mortality}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{600--607}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Gastrointestinal cancer precursor risk and mortality in pancreatic intraductal papillary mucinous neoplasms : a nationwide cohort study}},
  url          = {{http://dx.doi.org/10.1080/00365521.2024.2310162}},
  doi          = {{10.1080/00365521.2024.2310162}},
  volume       = {{59}},
  year         = {{2024}},
}