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Portuguese Pancreatic Club perspective on the surveillance strategy for intraductal papillary mucinous neoplasms : when and how to do it?

datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorVara-Luiz, Francisco
dc.contributor.authorFernandes, Alexandra
dc.contributor.authorBispo, Miguel
dc.contributor.authorVilas-Boas, Filipe
dc.contributor.authorCúrdia-Gonçalves, Tiago
dc.contributor.authorRodrigues-Pinto, Eduardo
dc.contributor.authorPinto-Marques, Pedro
dc.contributor.authorPortuguese Pancreatic Club, specialized section of the Portuguese Society of Gastroenterology
dc.date.accessioned2026-05-19T15:37:34Z
dc.date.available2026-05-19T15:37:34Z
dc.date.issued2025-12
dc.description.abstractBackground: Pancreatic cysts are increasingly recognized nowadays, with estimated prevalence that may reach 50% in aging populations. Most cysts are of benign origin, and only a small proportion has malignant potential, including intraductal papillary mucinous neoplasms (IPMNs). Since pancreatic cysts are common, the most important goal was to identify the small percentage at high risk of developing malignancy. The increased detection and awareness of IPMNs led to the development of several consensus and guidelines, with only the most recent being evidence-based. Summary: Current consensus guidelines recommend risk assessment to prioritize high-risk patients for malignancy. In the Fukuoka/Kyoto guidelines, the predictive factors of malignancy are called “high-risk stigmata” and “worrisome features.” Conversely, other guidelines consider the terms “absolute indication” and “relative indication” for surgery, as well as criteria for referral to multidisciplinary groups. In case of non-resected IPMNs, criteria for surveillance depend on cyst size, with magnetic resonance imaging pointed as the most consensual modality for follow-up, although the recommended imaging modality varies among consensus. In some situations, namely, older age, frailty/comorbidities, or stability of cyst size, follow-up discontinuation may be considered. Key Message: Performance of surveillance guidelines is measured by the ability to identify patients with high-grade dysplasia/early stage-invasive cancer. Guidelines with more intense protocols will likely lead to fewer missed cancers, balanced by a greater number of benign resections. Multidisciplinary management preferably in reference centers is of utmost importance given the indolent and complex nature of the disease, and a global evidence-based guideline that combines the several guidelines’ groups is mandatory to uniformize care. In this review, the Portuguese Pancreatic Club summarizes the risk assessment and surveillance strategy of a patient with an IPMN according to different guidelines in order to create an updated perspective and to guide clinical care.eng
dc.identifier.citationFrancisco Vara-Luiz, Alexandra Fernandes, Miguel Bispo, Filipe Vilas-Boas, Tiago Cúrdia-Gonçalves, Eduardo Rodrigues-Pinto, Pedro Pinto-Marques, The Portuguese Pancreatic Club, specialized section of the Portuguese Society of Gastroenterology; Portuguese Pancreatic Club Perspective on the Surveillance Strategy for Intraductal Papillary Mucinous Neoplasms: When and How to Do It?. GE Port J Gastroenterol 15 December 2025; 32 (6): 438–446. https://doi.org/10.1159/000547298
dc.identifier.doi10.1159/000547298
dc.identifier.issn2387-1954
dc.identifier.urihttp://hdl.handle.net/10400.26/63201
dc.language.isoeng
dc.peerreviewedyes
dc.publisherKarger
dc.relation.hasversionhttps://doi.org/10.1159/000547298
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectIntraductal papillary mucinous neoplasm
dc.subjectPancreatic cancer
dc.subjectSurveillance
dc.titlePortuguese Pancreatic Club perspective on the surveillance strategy for intraductal papillary mucinous neoplasms : when and how to do it?eng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.endPage446
oaire.citation.issue6
oaire.citation.startPage438
oaire.citation.titleGE – Portuguese Journal of Gastroenterology
oaire.citation.volume32
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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