title: Does a family history of pancreatic ductal adenocarcinoma and cyst size influence the follow-up strategy for intraductal papillary mucinous neoplasms of the pancreas?
abstract: OBJECTIVE
  This study aimed to evaluate the relationship between pancreatic ductal adenocarcinoma (PDAC) family history and PDAC development in patients followed up for intraductal papillary mucinous neoplasms (IPMNs) and to assess the cyst size relevance in determining follow-up strategies.
  
  
  METHODS
  We analyzed 300 patients with branch duct and mixed-type IPMN who were followed up at our facility.
  
  
  RESULTS
  Among the patients aged 70 years or older, the frequency of PDAC did not differ significantly between those with 1 first-degree relative with PDAC and those without a family history. Although patients with IPMNs of greater than or equal to 30 mm were followed up for a significantly shorter duration than those patients with IPMNs of less than 30 mm, the frequency of IPMN progression and malignant IPMN was significantly greater in the former. The frequency of IPMN progression and pancreatic cancer did not differ significantly according to IPMN size (<10, 10-20, and 20-30 mm) in cases without mural nodules.
  
  
  CONCLUSIONS
  Patients with 1 first-degree relative with PDAC can be followed up using the same criteria for patients without a family history. Special attention should be paid to IPMN progression and malignant transformation in patients with IPMNs of greater than or equal to 30 mm, but cyst size need not be considered when determining follow-up strategies for patients with IPMNs of less than 30 mm without mural nodules.
authors.affiliation: From the Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Mandai
authors.forename: Koji
authors.initials: K
authors.lastname: Uno
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Yasuda
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology*; D002288:Adenocarcinoma, Mucinous / Q000235:genetics / Q000473:pathology*; D000231:Adenocarcinoma, Papillary / Q000235:genetics / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000235:genetics / Q000473:pathology*; D016009:Chi-Square Distribution; D018450:Disease Progression; D005190:Family; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000235:genetics / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000473:pathology*; D012189:Retrospective Studies