Risk of pancreatic cancer and high-grade dysplasia in resected main-duct and mixed-type intraductal papillary mucinous neoplasms: A prevalence meta-analysis

Authors

Omar Mahmud, Aga Khan UniversityFollow
Asad Saulat Fatimi, Aga Khan UniversityFollow
Mahip Grewal, NYU Grossman School of Medicine, United States
Charles DiMaggio, NYU Grossman School of Medicine, United States
D Brock Hewitt, NYU Grossman School of Medicine, United States
Ammar A. Javed, NYU Grossman School of Medicine, United States
Christopher L. Wolfgang, NYU Grossman School of Medicine, United States
Greg D. Sacks, NYU Grossman School of Medicine, United States

Document Type

Review Article

Department

Medical College Pakistan

Abstract

Background: Current guidelines recommend the resection of main duct- (MD) and mixed-type (MT) intraductal papillary mucinous neoplasms (IPMN) based on specific risk criteria to prevent or treat pancreatic cancer in selected patients. This paradigm follows high rates of malignancy observed in published surgical series. The aim of this systematic review and meta-analysis was to provide robust, pooled rates of invasive carcinoma (IC) and high-grade dysplasia (HGD) in resected MD- and MT-IPMNs of the pancreas.
Methods: The PubMed, Embase, Scopus, Web of Science, and Cochrane CENTRAL databases were systematically searched. Studies that reported rates of IC or HGD, diagnosed by histopathology of surgical specimens, in MD- or MT-IPMNs were included. Pooled prevalence with 95 % confidence interval (95 % CI) was calculated using a random effects model. Galbraith plots were used to evaluate heterogeneity. Risk of bias was assessed using the National Institutes of Health Quality Assessment Tool.
Results: Based on 51 studies, 59 % (95 % CI: 54 %, 64 %) of resected MD- and MT-IPMN had IC or HGD, with IC in up to 39 % (95 % CI: 33 %, 44 %) of lesions and HGD in 20 % (95 % CI: 16 %, 25 %). Most studies were deemed to be of good quality and Galbraith plots demonstrated high concordance.
Conclusions: These results confirm the rates of IC and HGD in resected MD/MT-IPMNs. However, a significant proportion of patients have benign lesions, and future research is needed to develop precise diagnostics to distinguish between patients with and without high-risk or cancerous disease.

Comments

Pagination are not provided by the author/publisher.

Publication (Name of Journal)

European Journal of Surgical Oncology

DOI

10.1016/j.ejso.2025.109742

Recommended Citation

Mahmud, O., Fatimi, A. S., Grewal, M., DiMaggio, C., Hewitt, D., Javed, A. A., Wolfgang, C. L., Sacks, G. D. (2025). Risk of pancreatic cancer and high-grade dysplasia in resected main-duct and mixed-type intraductal papillary mucinous neoplasms: A prevalence meta-analysis. European Journal of Surgical Oncology, 51(7), 109742.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/516