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

Vujasinovic, Miroslav (author)
Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska institutet, Stockholm, Sweden
Elbe, Peter (author)
Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
Ekheden, Isabella (author)
Department of Laboratory Medicine, Karolinska Institutet, Stockholm, weden
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Wang, Qiao-Li (author)
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston MA, USA
Thuresson, Marcus (author)
Statisticon AB, Uppsala, Sweden
Roelstraete, Bjorn (author)
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Ghazi, Sam (author)
Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
Löhr, J. -Matthias (author)
Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
Ludvigsson, Jonas F., 1969- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Celiac Disease Center, Department of Medicine, Columbia University Medical Center, NY, USA; Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden
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 (creator_code:org_t)
Taylor & Francis, 2024
2024
English.
In: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708.
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Keyword

IPMN
cancer
gastrointestinal
adenoma
Barrett

Publication and Content Type

ref (subject category)
art (subject category)

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