title: International Intraductal Papillary Mucinous Neoplasms Registry: Long-Term Results Based on the New Guidelines.
abstract: The aim of this study was to analyze the outcomes of a long-term intraductal papillary mucinous neoplasm (IPMN) registry and evaluate new guidelines.
  
  
  
  A prospectively maintained IPMN registry involving 6 centers in Europe and the United States was used to collect the data. Patients with more than 1-year follow-up and no malignancy diagnosed within the first 3 months of surveillance were included.
  
  
  
  From 1999 to 2014, 620 patients were included. The median follow-up time was 3 years. Thirty-seven (6%) patients developed malignancy with a median time from IPMN diagnosis to malignancy of 10.3 months. The 1-, 5-, and 10-year actuarial rates of disease-free survival were 97%, 93%, and 92% respectively. Four hundred thirty-one patients met criteria for low-risk branch duct IPMN consisting of cyst size less than 3 cm, with no solid component or main duct dilation. Eight malignancies were diagnosed in this subgroup, all of them within the first 5 years. From this subcohort, 112 patients had a follow-up time of more than 5 years, and no malignancy was diagnosed.
  
  
  
  In IPMN lesions with low-risk features at baseline, the risk of progression to malignancy after the first 5 years of follow-up was minimal. Furthermore, the main cyst characteristics remained unchanged during their surveillance.
authors.affiliation: From the *Department of Gastroenterology and †Clinical Studies Unit, Mayo Clinic, Jacksonville, FL; ‡Department of Gastroenterology, San Raffaele Scientific Institute, Milan; §Department of Gastroenterology, Azienda Universitario-Ospedaliera San Giovanni Battista, Turin; ∥Department of Gastroenterology, Humanitas Research Hospital, Milan; and ¶Department of Gastroenterology, University of Bologna/Hospital of Imola, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Moris
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Woodward
authors.forename: Verna J
authors.initials: VJ
authors.lastname: Skinner
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Arcidiacono
authors.forename: Maria C
authors.initials: MC
authors.lastname: Petrone
authors.forename: Claudio
authors.initials: C
authors.lastname: De Angelis
authors.forename: Selene
authors.initials: S
authors.lastname: Manfrè
authors.forename: Silvia
authors.initials: S
authors.lastname: Carrara
authors.forename: Manol
authors.initials: M
authors.lastname: Jovani
authors.forename: Pietro
authors.initials: P
authors.lastname: Fusaroli
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000231:Adenocarcinoma, Papillary / Q000473:pathology*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010181:Pancreatic Cyst / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000473:pathology*; D017410:Practice Guidelines as Topic; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies