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Revista de Gastroenterología del Perú

versión impresa ISSN 1022-5129

Resumen

CHACALTANA MENDOZA, Alfonso et al. Clinical profile and survival analysis in patients with intraductal papilar mucinous neoplasm by endoscopic ultrasound. Rev. gastroenterol. Perú [online]. 2020, vol.40, n.1, pp.52-60. ISSN 1022-5129.

Introduction:

Intraductal papillary mucinous neoplasms (IPMN) are diagnosed more frequently because the higher use of radiologic exams, in that sense they are a great challenge to define its management and treatment in relation to its potential malignant transformation.

Objective:

To describe IPMN clinical profile, endoscopic ultrasound (EUS) characteristics and survival in all patients diagnosed with IPMN by EUS at HNERM.

Materials and methods:

Retrospective cohort of patients with IPMN diagnosed at HNERM by EUS from 2013 to 2018. Descriptive statistics was used for clinical profile and EUS characteristics. Kaplan Meir Method and Cox regression analysis was applied for survival analysis.

Results:

133 patients with IPMN were included. Medium age was 68.6 years, 80 (60.2%) were female. According to IPMN subtypes, 89 (66.9%) originated from secondary branch, 23 (17.3%) from main duct (MD) and 21 (15.8%) were mixed type (MT). Head of pancreas was the main localization (41.4%). In follow-up, 22 (16.5%) were derived to surgery. Mortality occurred in 16.5% (22 cases) after a median follow-up of 522 days. Malignant transformation was diagnosed in 6% (8 cases). Survival was 86.8% (IC 95%, 79.6-91.6) at 1 year and 81.9% (IC95%, 73.3-88.0) at 3 years. Univariate analysis demonstrated that factors associated to survival were MD-IPMN (p=0.02) y MT-IPMN (p=0.005), male gender (p=004), nodule size ≥30 mm (p=0.000), presence of nodules (p=0.014) and Wirsung ≥10 mm (p=0.01). Multivariate analysis showed that predictive factors for survival were MD-IPMN (HR=6.3, p=0.005), MT-IPMN (HR=4.9, p=0.008) and nodule size ≥30 mm (HR=7.1, p=0.000).

Conclusions:

Diagnosis of MD-IPMN and MT-IPMN are predictive factors for survival as well as nodule size ≥ 30mm.

Palabras clave : Pancreatic cysts; Intraductal papillary-mucinous neoplasm, pancreatic; Survival.

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