Is Surgery Better for Patients with Branch Duct IPMNs with Worrisome Features?

Branch duct intraductal papillary mucinous neoplasms (IPMNs) with worrisome features often present a clinical conundrum — should a patient undergo relatively high-risk pancreatic surgery to remove the lesion or undergo costly screening in hopes of finding evidence of significant change before cancer can develop? A new study attempts to answer this very question.

The authors used a Markov decision analysis model to compare two management strategies for patients with branch duct IPMN with worrisome features: early resection or long-term surveillance. The authors estimated the utility of outcomes, probabilities of transitions between disease states, and chances of surgical morbidity, based on data published between 1997 and 2014.

Early surgical …