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The Landmark Series: Intraductal Papillary Mucinous Neoplasms of the Pancreas-From Prevalence to Early Cancer Detection

Journal

ANNALS OF SURGICAL ONCOLOGY
Volume 30, Issue 3, Pages 1453-1462

Publisher

SPRINGER
DOI: 10.1245/s10434-022-12870-w

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Modern studies show a high prevalence of pancreatic cysts in the general population, with half of them being pancreatic cystic neoplasms that have different degrees of malignant potential. Intraductal papillary mucinous neoplasms are the most common type and can lead to pancreatic adenocarcinoma. These cysts are one of the few precursors of pancreatic cancer that can be identified through radiographic imaging, allowing for early detection and surgical resection. Due to their high prevalence and potential for malignant progression, it is important to discuss the best management of IPMNs and improve the current standard of care.
Modern series report a prevalence of pancreatic cysts in the general population of up to 50% in prospective studies. Of these, about half will be pancreatic cystic neoplasms (PCNs) that have varying degrees of malignant potential. Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are the most common PCNs and are known predecessors of pancreatic adenocarcinoma. Critically, they are one of the only radiographically identifiable precursors of pancreatic cancer and thus provide an opportunity for early cancer detection and surgical resection with curative intent. The combination of high prevalence and potential for malignant degeneration underscore the relevance of discussing the best management of IPMNs and improving the existing standard of care. Landmark data on IPMN prevalence, guidelines, surveillance, biomarkers, and immune landscape are highlighted.

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