Obesity is a risk factor for pancreatic precancerous lesions (PanIN)

Background: The strategy of following up IPMN, in the majority of patients is currently considered best clinical practice, even though consensus regarding an appropriate follow-up interval is lacking. Aims: This study analyzes the results of a follow-up program for patients with IPMN. Patients&methods: From January 2008 toDecember 2013, 503 patients diagnosed with IPMN were observed at the Pancreas Unit of Karolinska Institute. 452 patients (89.8%)were followed-up,while 51 (10.2%) underwent surgery. The patients under follow-up were included in this study Results: Overall, 452 patients were analyzed. The mean follow-up was 932 days. 395 patients (87.4%) were under surveillance according to the prevailing guidelines (group 1), whereas 57 (12.6%) patients (group 2) were followed-up because of contraindications for surgery. In group 1, 55 patients (13.9%) required surgery for progression of their IPMN after a median follow-up of 560 days. In 2 patients (0.5%), a synchronous pancreatic cancer developed during follow-up. In group 1, 33 patients (8.3%) died under follow-up: 4 (1%) due to IPMN progression, 5 (1.3%) because of extrapancreatic cancer and 24 (6%) for other causes. In group 2, 22 patients (38.6%) died due to IPMN progression 10 (17.5%), extrapancreatic cancer, 5 (8.8%), or for other reasons 7 (12.3%). Conclusion: This study confirms the safety of a surveillance program for patients with non-surgical IPMN. Incidence of pancreatic cancer and IPMN-relatedmortality were low during follow-up. Even if patients with an indication for surgical treatment were for excluded from surgery for various reasons, survival was acceptable. Abstracts / Pancreato