Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors: lines of therapy
5 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Surveillance | MRI or endoscopic ultrasound at intervals set by cyst size, continued while the patient remains a surgical candidate; the remaining pancreas is followed after resection. | Kyoto guidelines for the management of IPMN (Pancreatology 2024) | 40 |
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Risk group | High-risk stigmata | Resection (pancreatoduodenectomy or distal pancreatectomy) for obstructive jaundice, an enhancing mural nodule of 5 mm or more, a main duct of 10 mm or more, or positive cytology, in patients fit for surgery. | Kyoto guidelines for the management of IPMN (Pancreatology 2024) | 40 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Incidental cyst | Characterise with MRI and MRCP or pancreas-protocol CT; endoscopic ultrasound with fluid analysis when the cyst type is unclear or worrisome features are present. | Kyoto guidelines for the management of IPMN (Pancreatology 2024) | 66 | |
| All comers | Worrisome features | Endoscopic ultrasound and fluid sampling; resection or short-interval surveillance depending on findings, age and fitness. | Kyoto guidelines for the management of IPMN (Pancreatology 2024) | 40 | |
| All comers | Invasive carcinoma in an IPMN | Staged and treated as pancreatic ductal adenocarcinoma with resection and adjuvant chemotherapy. | NCCN Guidelines: Pancreatic Adenocarcinoma | 87 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.