Branch-duct intraductal papillary mucinous neoplasm: a retrospective study on neoplastic risk after 5 years of surveillance
Bibliographic record
Abstract
Objectives: Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains controversial, particularly regarding cysts follow-up >5 years. The primary endpoint of this study was to assess the risk of malignant transformation of presumed BD-IPMN during follow-up and identify clinical and morphological predictors of malignancy. Methods: We performed a retrospective analysis of data from all patients with a presumed BD-IPMN diagnosis at the CIUSSS de l’Estrie CHUS, from 2004 to 2018. Results: The final database included 380 patients with presumed BD-IPMN with a median follow-up of 43.9 months (interquartile range [IQR] 28.6–73.3 months). Mean age at diagnosis was 65.5 years [27–90], 159 patients (42.8%) were male and 17 patients (4.5%) underwent resection of their lesion during their surveillance period. In our cohort, 132 patients (34.7%) had a follow-up of >5 years. Overall risk of malignancy was 2.1% [0.9%–4.1%]. During follow-up, neoplastic transformation was observed in 2 of 132 patients (1.5%) surveilled >5 years. Malignancy was significantly associated with cyst growth >2.5 mm/y (57.1% vs 5.8%; P < .001) dilated MPD (71.4% vs 4.9%; P < .001), solid component (71.4% vs 1.3%; P < .001), positive cytology (37.5% vs 0.5%; P < .001), development of high-risk stigmatas (87.5% vs 1.9%; P < .001), or worrisome features (87.5% vs 23.9%; P < .001) during follow-up and symptoms of jaundice (25% vs 0.5%; P = .002) and abdominal pain (50% vs 9.4%; P = .005). Conclusion: While overall malignancy risk remains low in presumed BD-IPMN, continuous surveillance should be pursued after 5 years in surgically fit individuals, particularly in patients who develop our identified risk factors.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".