{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:24:54Z","timestamp":1784733894868,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Backgrounds<\/jats:title><jats:p>Few data are available for surveillance decisions focusing on factors related to mortality, as the primary outcome, in intraductal papillary mucinous neoplasm (IPMN) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to identify imaging features and patient backgrounds associated with mortality risks by comparing pancreatic cancer (PC) and comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively conducted a multicenter long\u2010term follow\u2010up of 1864 IPMN patients. Competing risk analysis was performed for PC\u2010 and comorbidity\u2010related mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the median follow\u2010up period of 5.5\u00a0years, 14.0% (261\/1864) of patients died. Main pancreatic duct \u22655\u00a0mm and mural nodules were significantly related to all\u2010cause and PC\u2010related mortality, whereas cyst \u226530\u00a0mm did not relate. In 1730 patients without high\u2010risk imaging features, 48 and 180 patients died of PC and comorbidity. In the derivation cohort, a prediction model for comorbidity\u2010related mortality was created, comprising age, cancer history, diabetes mellitus complications, chronic heart failure, stroke, paralysis, peripheral artery disease, liver cirrhosis, and collagen disease in multivariate analysis. If a patient had a 5 score, 5\u2010 and 10\u2010year comorbidity\u2010related mortality is estimated at 18.9% and 50.2%, respectively, more than 7 times higher than PC\u2010related mortality. The model score was also significantly associated with comorbidity\u2010related mortality in a validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates main pancreatic duct dilation and mural nodules indicate risk of PC\u2010related mortality, identifying patients who need periodic examination. A comorbidity\u2010related mortality prediction model based on the patient's age and comorbidities can stratify patients who do not require regular tests, especially beyond 5\u00a0years, among IPMN patients without high\u2010risk features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>T2022\u20100046.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12540","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T17:24:29Z","timestamp":1708190669000},"page":"614-626","source":"Crossref","is-referenced-by-count":3,"title":["Identifying predictors for comorbidities related mortality versus pancreatic cancer related mortality in patients with intraductal papillary mucinous neoplasm"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8838-4410","authenticated-orcid":false,"given":"Katsunori","family":"Sekine","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and 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