Age should not be used to determine fitness for hepatectomy for colorectal liver metastases

cystic fluid analysis, 115 (49%) were BD-IPMN, 41 (18%) were serous cystadenoma, 39 (17%) were pseudocyst, 28 (12%) were mucinous cystic neoplasm (MCN), 5 (2%) main duct IPMNs (MD-IPMN) and 6 (2%) uncharacterizable cysts. Ten patients (9%) with BD-IPMN, 5 patients (80%) with MD-IPMN and all patients (28) with MCNs underwent surgical intervention. One patient with MD-IPMN did not undergo surgical intervention due to advanced age and multiple comorbidities. One hundred and eight patients with BD-IPMNs are currently being followed clinically and radiographically, while 7 patients were lost to follow-up. In the 115 patients with BD-IPMN, 4 patients were b59 years of age, 32 were 60-69, 34 were 70-79, and 25 were 80-89. Average cyst size (2.34 cm) was greatest in 7079 year age group. Seventy-seven patients (67%) were N65 years vs. 38 patients (33%) b65 years, lesion sizes were 2.05 cm and 1.31 cm respectively. Two patients with BD-IPMN were found to have pancreatic cancer on follow-up and 1 during surgical resection with average age of 80 years. Median follow-up for office visits and surveillance imaging was 12 months. One hundred and five (97%) patients with BD-IPMN are currently cancer free. Average cyst size of patients with and without cancer, are 3.1 cm and 1.82 cm respectively. Conclusion: BD-IPMNs are the most common pancreatic cystic pathologies identified by EUS, however there is little evidence in the literature to guide the frequency and type of surveillance for BD-IPMN. Within our data set, the data showed that elderly patients (N65 years of age) on average have larger size cysts and higher chance ofmalignancy. It suggests patients b65 could be imaged less frequently unless there is a significant change in size of cyst. Further prospective studies including multi-center investigations are necessary to better clarify management and surveillance strategy for this unresolved entity.