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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| Autores principales: | , , , , , , , |
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| Formato: | Article (Journal) |
| Lenguaje: | inglés |
| Publicado: |
21 April 2026
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| In: |
Annals of surgical oncology
Year: 2026, Volumen: 33, Número: 7, Pages: 6820-6826 |
| ISSN: | 1534-4681 |
| DOI: | 10.1245/s10434-026-19690-2 |
| Acceso en línea: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1245/s10434-026-19690-2
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| Notas de Autor: | 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 |
| Sumario: | 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. |
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| Notas: | Online veröffentlicht: 21. April 2026 Gesehen am 12.06.2026 |
| Descripción Física: | Online Resource |
| ISSN: | 1534-4681 |
| DOI: | 10.1245/s10434-026-19690-2 |