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We evaluated 10-year relapse, malignancy, metabolic\/nutritional changes, and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 83 CS-treated patients with type 1 AIP followed for\u2009\u2265\u200910\u00a0years or until death, assessing: relapse and risk factors; standardized incidence ratios (SIRs) and risk factors for malignancies; 10-year changes in HbA1c and serum albumin; CS-related adverse events; and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cumulative relapse rates at 1, 3, 5, 7, and 10\u00a0years were 11.0%, 26.9%, 38.3%, 50.0%, and 56.9%. CS discontinuation independently predicted relapse, whereas serum IgG4 normal at diagnosis or normalized after CS was protective. Overall malignancy risk was not increased (SIR 1.00; 95%CI 0.59\u20131.42), while pancreatic cancer (PC) showed a numerically higher SIR (1.98 overall; 2.96\u2009\u2265\u20095\u00a0years postdiagnosis). In 72 patients with 10-year laboratory follow-up, HbA1c improved at 3\u00a0years but tended to worsen at 10\u00a0years, and serum albumin declined by 10\u00a0years (mean\u2009\u2212\u00a00.27\u00a0g\/dL), exceeding age-related norms. Preexisting diabetes attenuated albumin decline. Ten-year survival was 85.5%, and CS maintenance was associated with better OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Type 1 AIP shows progressive relapse and metabolic deterioration over a decade, while CS maintenance and IgG4 normalization confer long-term protection. Although the overall risk of malignancy was not increased, the incidence of PC during late follow-up was slightly higher. These findings highlight the need for continuous monitoring for relapse, PC, and nutritional decline in AIP management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00535-026-02448-8","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T18:25:04Z","timestamp":1779733504000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A decade of clinical course and prognostic determinants in type 1 autoimmune pancreatitis: insights from a 10-year longitudinal multicenter retrospective study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0341-1123","authenticated-orcid":false,"given":"Masaki","family":"Miyazawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Takatori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Nishitani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Komura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiichiro","family":"Kaji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Yano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Kitamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryotaro","family":"Nakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Matsukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Takemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yanagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Nagai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Kido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Takata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Seki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouki","family":"Nio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriho","family":"Iida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Shimakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"issue":"7","key":"2448_CR1","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1007\/BF02285209","volume":"40","author":"K Yoshida","year":"1995","unstructured":"Yoshida K, Toki F, Takeuchi T, et al. 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