INTRODUCTION Aging has been implicated in the development of various cancer types. No study has specifically investigated age at intraductal papillary mucinous neoplasm (IPMN) diagnosis in relation to the long-term risk of pancreatic carcinogenesis. METHODS Within a prospective cohort of 4,104 patients diagnosed with pancreatic cysts, we identified 3,142 patients with IPMNs and examined an association of age at IPMN diagnosis with the incidence of pancreatic carcinoma. Using the multivariable competing-risks proportional hazards regression model, we estimated subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs) for pancreatic carcinoma incidence according to age at IPMN diagnosis. RESULTS During 22,187 person-years of follow-up, we documented 130 patients diagnosed with pancreatic carcinoma (64 with IPMN-derived carcinoma and 66 with concomitant ductal adenocarcinoma). Older age at IPMN diagnosis was associated with a higher risk of pancreatic cancer incidence ( Ptrend = 0.002). Compared with patients younger than 55 years, patients aged 55-64, 65-74, and ≥ 75 years had adjusted SHRs of 1.80 (95% CI, 0.75-4.32), 2.56 (95% CI, 1.10-5.98), and 3.31 (95% CI, 1.40-7.83), respectively. Patients aged 70 years and older had a numerically similar adjusted SHR compared with patients younger than 70 years with worrisome features defined by the international consensus guidelines (1.73 [95% CI, 1.01-2.97] and 1.66 [95% CI, 0.89-3.10], respectively). DISCUSSION Older patients with IPMNs were at a higher risk of developing pancreatic carcinoma during surveillance. Surgically fit elderly patients may be good candidates for periodic surveillance aimed at a reduction of pancreatic cancer-related deaths.

中文翻译：

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年龄较大是导管内乳头状粘液性肿瘤患者的一个令人担忧的特征：一项长期监测研究。


引言 衰老与多种癌症类型的发生有关。尚无研究专门调查导管内乳头状粘液性肿瘤 (IPMN) 诊断时的年龄与胰腺癌长期风险的关系。方法 在由 4,104 名诊断为胰腺囊肿的患者组成的前瞻性队列中，我们确定了 3,142 名患有 IPMN 的患者，并检查了 IPMN 诊断时的年龄与胰腺癌发病率的关系。使用多变量竞争风险比例风险回归模型，我们根据 IPMN 诊断时的年龄估计了胰腺癌发病率的次分布风险比 (SHR) 和 95% 置信区间 (CI)。结果 在 22,187 人年的随访中，我们记录了 130 名被诊断患有胰腺癌的患者（64 名患有 IPMN 衍生癌，66 名伴有导管腺癌）。 IPMN 诊断时年龄较大与胰腺癌发病风险较高相关（Ptrend = 0.002）。与55岁以下的患者相比，55-64岁、65-74岁和≥75岁的患者调整后的SHR分别为1.80（95% CI，0.75-4.32）、2.56（95% CI，1.10-5.98）和3.31 （95% CI，1.40-7.83）。与国际共识指南定义的具有令人担忧特征的 70 岁以下患者相比，70 岁及以上患者的调整后 SHR 在数值上相似（1.73 [95% CI，1.01-2.97] 和 1.66 [95% CI，0.89-3.10]） ， 分别）。讨论 患有 IPMN 的老年患者在监测期间患胰腺癌的风险较高。适合手术的老年患者可能是定期监测的良好候选者，旨在减少胰腺癌相关死亡。