Can Long-term IPMN Surveillance Improve the Prognosis of Pancreatic Ductal Adenocarcinoma? Young Award

Background: IPMN is known as a risk factor of pancreatic ductal adenocarcinoma (PDAC) as well as that of IPMC. Whether long-time IPMN surveillance can lead to early diagnosis and favorable prognosis of PDAC is not clearly known.
Methods: We identified 1,541 patients diagnosed with PDAC between 1992 and 2021 and divided them into two groups: 57 diagnosed during IPMN surveillance (surveillance group) and the other 1,484 patients (non-surveillance group). We compared tumor characteristics and prognosis between the two groups. We used the Kaplan-Meier method and the log-rank test for survival analyses. In a matched analysis, the patients in non-surveillance group were matched one-to-ten with those in surveillance group for sex, age at cancer diagnosis, and year of cancer diagnosis.
Results: Cancer stages were 0-I/II-III/V in 5.3%/74%/21% in surveillance group and 1.7%/53%/46% in non-surveillance group; the patients in surveillance group were diagnosed at earlier stage. The five-year survival rate was significantly higher in surveillance group: 31.9% (95% CI, 17.2-47.6%) vs 12.7% (10.5-15.0%) (p = 0.007). In the matched analysis, five-year survival rate of surveillance group was also significantly higher than that of non-surveillance group (34.3% [18.6-50.7%] vs 15.4% [11.2-20.3%], p = 0.018).
Conclusions: IPMN surveillance may improve the prognosis of patients with PDAC.