{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:06:01Z","timestamp":1790845561141,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Nadia Valsecchi to S.C."},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Different surveillance strategies for patients with low-risk branch-duct (BD) intraductal papillary neoplasm (IPMN) have been described. The aim of this study was to describe the natural history of low-risk BD-IPMN, and to identify risk factors for the development of worrisome features (WF)\/high-risk stigmata (HRS) and of pancreatic malignancies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a multicentre retrospective study of patients with BD-IPMN who were under active surveillance between January 2006 and December 2015. Patients were eligible if they had a low-risk lesion and had a minimum follow-up of 24 months. Outcomes were development of WF\/HRS or cytologically\/histologically confirmed malignant IPMN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 837 patients included, 168 (20 per cent) developed WF\/HRS. At the end of the observation time, 132 patients (79 per cent) with WF\/HRS were still under surveillance without progression to pancreatic cancer. Factors associated with the development of WF or HRS in multivariable analysis included localized nodules (versus diffuse: hazard ratio (HR) 0.43, 95 per cent c.i. 0.26 to 0.68), cyst size 15\u201319\u2005mm (versus less than 15\u2005mm: HR 1.88, 1.23 to 2.87) or at least 20\u2005mm (versus less than 15\u2005mm: HR 3.25, 2.30 to 4.60), main pancreatic duct size over 3\u2005mm (versus 3\u2005mm or less: HR 2.17, 1.41 to 3.34), and symptoms at diagnosis (versus no symptoms: HR 2.29, 1.52 to 3.45). Surveillance in an endoscopy-oriented centre was also associated with increased detection of WF or HRS (versus radiology-oriented: HR 2.46, 1.74 to 3.47).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Conservative management of patients with low-risk BD-IPMN is safe and feasible.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znac103","type":"journal-article","created":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T20:30:44Z","timestamp":1647549044000},"page":"617-622","source":"Crossref","is-referenced-by-count":20,"title":["Identification of patients with branch-duct intraductal papillary mucinous neoplasm and very low risk of cancer: multicentre study"],"prefix":"10.1093","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1435-3651","authenticated-orcid":false,"given":"Domenico","family":"Tamburrino","sequence":"first","affiliation":[{"name":"Pancreatic Surgery Unit, Vita-Salute University, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"de Pretis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Pancreas Institute, University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"P\u00e9rez-Cuadrado-Robles","sequence":"additional","affiliation":[{"name":"Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc , Brussels , Belgium"},{"name":"Department of Gastroenterology, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Uribarri-Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Complejo Hospitalario de Navarra , Pamplona , Spain"},{"name":"Department of Gastroenterology, Hospital Universitario de Santiago de Compostela , Santiago de Compostela , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeeshan","family":"Ateeb","sequence":"additional","affiliation":[{"name":"Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Universitetsjukhuset i Huddinge , Huddinge , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Belfiori","sequence":"additional","affiliation":[{"name":"Pancreatic Surgery Unit, Vita-Salute University, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-4704","authenticated-orcid":false,"given":"Patrick","family":"Maisonneuve","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Capurso","sequence":"additional","affiliation":[{"name":"Digestive and Liver Disease Unit, Sant\u2019Andrea Hospital , Rome , Italy"},{"name":"Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Vanella","sequence":"additional","affiliation":[{"name":"Digestive and Liver Disease Unit, Sant\u2019Andrea Hospital , Rome , Italy"},{"name":"Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Petrone","sequence":"additional","affiliation":[{"name":"Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Giorgio","family":"Arcidiacono","sequence":"additional","affiliation":[{"name":"Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1494-2184","authenticated-orcid":false,"given":"Yrjo","family":"Vaalavuo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University , Tampere , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Frulloni","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Pancreas Institute, University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Enrique","family":"Dominguez-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario de Santiago de Compostela , Santiago de Compostela , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre H.","family":"Deprez","sequence":"additional","affiliation":[{"name":"Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc , Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Falconi","sequence":"additional","affiliation":[{"name":"Pancreatic Surgery Unit, Vita-Salute University, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7400-013X","authenticated-orcid":false,"given":"Marco","family":"del Chiaro","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of Colorado , Anschutz Medical Campus, Denver, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Crippa","sequence":"additional","affiliation":[{"name":"Pancreatic Surgery Unit, Vita-Salute University, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Laukkarinen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University , Tampere , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"2023063011113878100_znac103-B1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.pan.2018.11.014","article-title":"Systematic review 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