SURVEILLANCE OF SUB-CENTIMETER SIDE-BRANCH IPMNS: RISK OF INVASIVE DISEASE AND FOLLOW-UP RECOMMENDATIONS

Define the risk associated with sub-centimeter Side-Branch Intraductal Papillary Mucinous Neoplasms (SB-IPMN) and propose a surveillance strategy based on this cohort. SB-IPMNs are increasingly discovered with the growing use of high-fidelity cross-sectional imaging, particularly sub-centimeter (2 cross-sectional imaging studies >6 months apart. Clinically-relevant progression (CR-Progression) has been previously defined by development of symptoms, worrisome/high-risk stigmata, or invasive cancer (IC). Growth >5mm in 2years is considered CR-Progression; size>3cm alone is not. One-thousand patients were included, 291 (29.1%) with SB-IPMN1cm (p=0.090). CR-progression was less common in the sub-centimeter group (7.2% vs. 19%, log-rank p