{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:19:35Z","timestamp":1789391975935,"version":"build-2803163510"},"reference-count":110,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP4K11914"],"award-info":[{"award-number":["JP4K11914"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Surveillance strategies for presumed low\u2010risk branch\u2010duct intraductal papillary mucinous neoplasms (BD\u2010IPMNs) remain controversial, especially in the absence of malignancy predictors. This systematic review and meta\u2010analysis aimed to evaluate the impact of age on surveillance decisions for BD\u2010IPMNs without high\u2010risk features at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, a systematic search (January 2006\u2013August 2024) using the terms \u201cepidemiology\u201d and \u201cpancreatic intraductal neoplasm\u201d was conducted. Sixty\u2010six studies reporting the natural history of BD\u2010IPMNs without worrisome features (WF) or high\u2010risk stigmata (HRS) at diagnosis were included. Age\u2010related trends in IPMN progression and pooled incidence rates were analyzed by meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled incidence of WF was 2.0% per patient\u2010year and HRS was 0.46%. Advanced pancreatic neoplasia developed at 0.49% per patient\u2010year overall, decreasing to 0.26% during extended surveillance beyond 5\u2009years in stable cases. Concomitant pancreatic ductal adenocarcinoma occurred at 0.23% per patient\u2010year, with a median diagnosis time of 3.1\u2009years. Age alone was not a significant predictor of progression, though some studies proposed age thresholds when combined with other clinical factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Discontinuing surveillance may be reasonable in patients aged \u2265 75\u2009years with BD\u2010IPMN &lt; 20\u2009mm, no WF\/HRS, \u2265 5\u2009years of stability, and Charlson Comorbidity Index &gt; 3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.12159","type":"journal-article","created":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T23:44:18Z","timestamp":1748821458000},"page":"30-49","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Systematic Review on Different Values of Surveillance by Age in Branch Duct Intraductal Papillary Mucinous Neoplasms of the 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