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Shared decision-making in IPMN of the pancreas: a framework for surgical decisions under uncertainty

Management of intraductal papillary mucinous neoplasms (IPMNs) requires choosing between surgical resection and active surveillance, yet current diagnostic tools cannot reliably distinguish which lesions harbor high-grade dysplasia or invasive cancer. As a result, many patients undergo major pancrea...

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Autori principali: Sacks, Greg (Autore) , Pleines, Viola (Autore) , Hunter, Madeleine D. (Autore) , Habib, Joseph R. (Autore) , Javed, Ammar A. (Autore) , Marchegiani, Giovanni (Autore) , Wolfgang, Christopher L. (Autore) , Lee, Clara N. (Autore)
Natura: Article (Journal)
Lingua:inglese
Pubblicazione: 21 April 2026
In: Annals of surgical oncology
Year: 2026, Volume: 33, Fascicolo: 7, Pages: 6820-6826
ISSN:1534-4681
DOI:10.1245/s10434-026-19690-2
Accesso online:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1245/s10434-026-19690-2
Testo
Note sull'autore:Greg D. Sacks, MD, MPH, PhD, Viola Pleines, MD, Madeleine D. Hunter, MD, Joseph R. Habib, MD, PhD, Ammar A. Javed, MD, PhD, Giovanni Marchegiani, MD, PhD, Christopher L. Wolfgang, MD, PhD, Clara N. Lee, MD
Descrizione
Riassunto:Management of intraductal papillary mucinous neoplasms (IPMNs) requires choosing between surgical resection and active surveillance, yet current diagnostic tools cannot reliably distinguish which lesions harbor high-grade dysplasia or invasive cancer. As a result, many patients undergo major pancreatic surgery for low-grade disease, while others are observed until progression emerges. This uncertainty contributes to substantial variation in surgeon risk estimates, intervention thresholds, and treatment recommendations. Patients likewise differ in their tolerance for cancer risk, views on surgical morbidity, perceived burden of ongoing surveillance, and desired role in decision-making, making IPMN a distinctly preference-sensitive clinical scenario. Although recent international guidelines acknowledge the importance of incorporating patient values into management decisions, practical frameworks for doing so remain underdeveloped.
Descrizione del documento:Online veröffentlicht: 21. April 2026
Gesehen am 12.06.2026
Descrizione fisica:Online Resource
ISSN:1534-4681
DOI:10.1245/s10434-026-19690-2

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