title: Risk for mortality from causes other than pancreatic cancer in patients with intraductal papillary mucinous neoplasm of the pancreas.
abstract: OBJECTIVE
  The long-term prognosis in patients with intraductal papillary mucinous neoplasm (IPMN) has not been determined. The aim of this study was to elucidate the risk for nonpancreatic cancer-specific mortality in patients with IPMN.
  
  
  METHODS
  Seven hundred ninety-three patients with IPMN who were followed up more than 1 year were included in this study. Fine and Gray competing risk regression was used to assess the risk for mortality unrelated to pancreatic cancer. A comorbidity score at diagnosis was assigned using the Adult Comorbidity Evaluation 27.
  
  
  RESULTS
  After a median follow-up of 50 months, a high comorbidity score and age at diagnosis were significantly associated with a risk for mortality unrelated to pancreatic cancer. Adjusted hazards ratio and 95% confidence interval of each comorbidity burden were as follows: none, 1; mild, 2.68 (0.76-9.45; P = 0.124); moderate, 10.9 (3.19-37.1; P < 0.001); and severe, 32.0 (9.41-108.8; P < 0.001). Comorbidity burden did not affect the risk for pancreatic cancer-specific mortality.
  
  
  CONCLUSIONS
  Comorbidity and age at diagnosis was significantly related to mortality unrelated to pancreatic cancer in patients with IPMN. For patients at high risk for nonpancreatic cancer mortality, a follow-up management may be more reasonable than surgery.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. kkawakubo-gi@umin.ac.jp
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Kawakubo
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Naminatsu
authors.initials: N
authors.lastname: Takahara
authors.forename: Koji
authors.initials: K
authors.lastname: Miyabayashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Suguru
authors.initials: S
authors.lastname: Mizuno
authors.forename: Dai
authors.initials: D
authors.lastname: Mohri
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Natsuyo
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tateishi
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ijichi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tateishi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000401:mortality*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology / Q000401:mortality*; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors