Citations 2
Contemporary Adjuvant Chemotherapy for Intraductal Papillary Mucinous Neoplasms
Haugk, Beate , White, Steven, Marchegiani, Giovanni, Holmberg, Marcus, Zerbi, Alessandro, Lu, Zipeng , Inoue, Y., Choi, Munseok , Kang, Chang Moo, Visser, B., Corpelijn, Lieke, Andersson, Bodil, Bereza-Carlson, Paulina, Björnsson, Bergthor, Wennerblom, Johanna, Goh, Brian K. P., Hartman, V., Ahmad, Syed, Patel, Sameer, Berrevoet, Frederik, Mortensen, Kim Erlend, Roberts, K., Lynch, Calum, Gupta, Amit, Kleeff, Joerg, Addeo, Pietro, Friess, Helmut, Koea, Jonathan, Gomez, Dhanny , Gordon-Weeks, Alex, Doria, Cataldo, Tzimas, Georgios, Franklin, O., Månsson, C., Cabús, Santiago Sánchez, Bhogal, Ricky H. , Pathak, Samir, Honselmann, Kim Christin, Balakrishnan, Anita, Mann, Kulbir , Gill, Anthony J., Mittal, A, Samra, Jas, Athwal, Tejinderjit, Loveday, Benjamin, Bhardwaj, Neil, Menon, Krishna, Thapa, Prabin, Matsumoto, Ippei, Jamieson, Nigel, Rebours, Vinciane, Descourvières, Clémence, Davidson, BR, Soreide, Kjetil, Pandanaboyana, Sanjay, Collaborative, Adeno-IPMN2, Kumar, Ajit, González, Carol Natalia Clavijo, Lam, Shi, L’Official-German, Ivan, Bergner, Tina, Rosso, Edoardo , Giulianotti, Pier Cristoforo , Morreau, Mathew , Dili, Alexandra, Sotiropoulou, Maria , Kuzman, Matta , Büyükkasap, Ahmet Çağrı, Uludağ, Gökhan, McGuigan, Mari-Claire , Chouari, Tarak , Dogul, Ahmet, Doğu, Doğukan , Rebelo, Artur, Holewik, Franziska Bernadette, Plesa-Furda, Roxana, Revoredo, Fernando, Galanis, Ilias , Maharjan, Dhiresh, Ghorbani, Poya , Lind, Max, Ami, Katsuya , Vijayashanker, Aarathi , Alsaoudi, Tareq , Lundgren, Linda , Ellisa, Katrina, Hong, Paul , Gupta, Archit, MartinXu, Congde, Konstantoudakis, Georgios, Christophides, Thalis, Spurring, Eleanor Margaret, Iwao, Yasuhito, Pirklc, Martin, Vaitha, Ruhi , Tiwari, Navneet, Sheel, Andrea, Kotecha, Krishna , Stavrou, Gregor A., Patel, Rikhilroy, Misca, Mihaela , Hammond, John, Roalso, Marcus Thomas Thor, Soomro, Faiza H, Halimi, Asif , Kendall, Timothy, Patel, Visad, Stankic, Dunja, Dries, Pieter , Hein, Charlotte, Betram, Julia, Jacob, Rosetta, Wilson, Gregory, Redas, Souheil, Poškus, Augustas, Mosert, Paula Lucia, Šilinskaitė, Ugnė , Hirose, Yuki, Liu, Xue, Standaert, Lars, Kay, Tegan J, Nishida, Kenji, Peddakota, Vivek , Gupta, Amit , Kang, Chang Moo , Ven Fong, Zhi, Kang, Chang Moo , Lucocq, James E. , Marchegiani, Giovanni , Zerbi, Alessandro , Pagnanelli, Michele , Visser, B. , Andersson, Bodil , Bereza‐Carlson, Paulina , Björnsson, Bergþór , Wennerblom, Johanna Hansson , Labori, Knut Jørgen , Goh, Brian K P , Hartman, Vera , Berrevoet, Frederik Christiaan , Ausania, Fabio , Bertrand, Claude , Kleeff, Joerg, Addeo, Pietro , Bellotti, Ruben , Fong, Zhi Ven , Friess, Helmut , Koea, Jonathan , Gordon-Weeks, Alex Nicolas , Doria, Cataldo , Franklin, Oskar , Pathak, Samir , Honselmann, Kim C. , Balakrishnan, Anita , Harrison, Ewen M. , Gill, A J, Mittal, Anubhav, Samra, Jas , Athwal, Tejinderjit , Loveday, Benjamin P. T. , Teh, Catherine , Bhardwaj, Neil , Menon, Krishna, Matsumoto, Ippei , Jamieson, Nigel , Rebours, Vinciane , Søreide, Kjetil , Martlı, Hüseyin Fahri , Roeyen, Geert , Antonakis, Pantelis T. , Bramis, Konstantinos , Hall, Lewis A , Valle, Valentina , Connor, Saxon J. , Kapiris, Stylianos A. , Kerem, Mustafa , Rebelo, Artur , Plesa-Furda, R., Filho, Omero Pereira da Costa , Galanis, Ilias, Konstantoudakis, Georgios, Christophides, Thalis, McGuinness, Matthew James , Yaqub, Sheraz , Pellegrini, Riccardo , Perri, Giampaolo , Sheel, Andrea , Sheen, Amy , Evans, Daisy, Ghamarnejad, Omid , Karavias, Dimitrios D. , Roalsø, Marcus T. T. , Stankic, Dunja , Grubor, Nikica , Gulla, Aistė , Furukawa, Takaaki , Hirose, Yuki , Yin, Lingdi
JAMA Network Open | March 27, 2026 | Volume: 9 | Issue: 3 | Pages: e263688
10.1001/jamanetworkopen.2026.3688
Importance Adjuvant chemotherapy regimens may be administered after pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms (A-IPMNs), although the evidence supporting their use is limited. Objective To evaluate the survival benefit associated with contemporary adjuvant chemotherapy regimens after resection in A-IPMNs between 2017 and 2023. Design, Setting, and Participants This retrospective cohort study was an international, multicenter study with 69 participating centers across Europe, North America, South America, and the Asia-Pacific region. Patients undergoing resection for A-IPMNs were included. Data were analyzed from May to August 2025. Intervention Contemporary adjuvant chemotherapy regimens, such as gemcitabine-capecitabine (GemCap); 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFIRINOX), modified FOLFIRINOX (mFOLFIRINOX), and S-1. Main Outcome and Measure Overall survival (months). Results Among 1321 patients (median [IQR] age 70 [63 to 76] years; 713 males [54.0%] and 608 females [46.0%]), 781 patients (59.1%) received adjuvant chemotherapy, while in 181 patients (13.7%) it was omitted due to poor patient fitness. Of patients who received adjuvant chemotherapy, 568 patients (72.6%) received contemporary regimens, including GemCap (232 patients [29.7%]), FOLFIRINOX (176 patients [22.5%]), mFOLFIRINOX (71 patients [9.1%]), and S-1 (70 patients [9.0%]). The median (IQR) follow-up for the cohort was 64.2 (40.4 to 85.0) months, and the median overall survival was 73.8 months (95% CI, 66.4 to 81.9 months). After 90-day landmark analysis and exclusion of patients ineligible for chemotherapy, adjuvant chemotherapy vs no adjuvant chemotherapy (propensity score–matched populations, 243:243 patients) was not associated with improved overall survival (median, 82.3 months; 95% CI, 78.2 months to not applicable [NA] vs not reached; 95% CI, 75.3 months to NA; P = .58). Contemporary regimens vs no adjuvant chemotherapy (propensity score–matched populations, 309:309 patients) was not associated with longer survival, and a mean survival benefit greater than 4.2 months over 5 years was excluded (difference in restricted mean survival, 1.26 months; 95%, −1.72 to 4.24 months). Treatment outcomes did not vary by chemotherapy regimen or disease characteristic (eg, N stage or carbohydrate antigen 19-9 level). Conclusions and Relevance In this study, contemporary adjuvant chemotherapy was not associated with improved overall survival in A-IPMNs, and a randomized clinical trial is indicated.
International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG
Marchegiani, Giovanni, Hegyi, Peter, Archibugi, Livia, Valente, Roberto, Capurso, Gabriele, Witt, Heiko, Bonovas, Stefanos , Maisonneuve, Patrick, Verbeke, Caroline S., Dominguez‐Muñoz, J. Enrique, Scheers, Isabelle, Czakó, László, Wagner, R, Rebours, Vinciane, Öhlund, Daniel, Gubergrits, N. B. , Engjom, Trond , Neeße, Albrecht , Apte, Minoti V. , Braren, Rickmer, Bunduc, Stefania, Ceyhan, Güralp Onur, Chouhan, Manil Dinesh, Couvelard, Anne, Iglesia, Daniel de la, Drewes, Asbjørn Mohr, Sarasqueta, A. Farina, Francque, Sven, Frøkjær, Jens Brøndum, Iglesias‐Garcia, Julio, Garg, Pramod, Gerst, Felicia, Gulbinas, Antanas, Gürcinar, Ibrahim Halil, Heni, Martin , Jonas, E G, Kitano, M., Krag, Aleksander, Laukkarinen, J., Lipp, Mónika, Loveček, M., Martignoni, Marc E., Masip, Etna , Matsumoto, Ryotaro , Mozhynа, T. L. , Nosáková, Lenka, Ockenga, Johann , Pandanaboyana, Sanjay, Panić, Nikola , Papachristou, Georgios, Pasqua, Analía V. , Pawlak, Katarzyna Monika, Regel, Ivonne , Regnér, Sara, Singh, Vijay Kumar , Smits, M., Sung, Min Je , Tacelli, Matteo, Teutsch, Brigitta, Udrescu, Mihaela, Wilschanski, Michael , Yavas, Aslihan, Zamboni, G., Löhr, J. Matthias, Singh, Vijay , Drewes, Asbjørn Mohr , Regnér, Sara , Krag, Aleksander , Marchegiani, Giovanni , Pawlak, Katarzyna M. , Marchegiani, Giovanni , Hegyi, Peter , Archibugi, Livia , Bonovas, Stefanos , Verbeke, Caroline S , de-Madaria, Enrique , Wagner, Robert , Rebours, Vinciane , Öhlund, Daniel , Neesse, Albrecht , Bezmarević, Mihailo , Bunduc, Stefania , Iglesia, Daniel de la , Drenth, Joost P H , Gürcinar, Ibrahim Halil , Jonas, Eduard , Kitano, Masayuki , Obmann, Verena , Pandanaboyana, Sanjay , Pasqua, Analia Verónica , Pawlak, Katarzyna M , Regnér, Sara , Seicean, Andrada , Sung, Min Je , Taylor, Roy , Singh, Vijay P , Krag, Aleksander , Vujasinović, Miroslav , Demir, İhsan Ekin , Hegyi, Péter , Valente, Roberto, Capurso, Gabriele , Piovani, Daniele , Rosendahl, Jonas , Maisonneuve, Patrick , Karçaaltıncaba, Muşturay , Domínguez‐Muñoz, J. Enrique , Scheers, Isabelle , Czakó, László , Idılman, Ilkay S. , Overbeek, Kasper A. , Braren, Rickmer , Chouhan, Manil Dinesh , Couvelard, Anne , Cros, Jerome F. , de‐Madaria, Enrique , Drenth, Joost P.H. , Fracasso, Pierluigi , Francque, Sven , Frøkjær, Jens Brøndum , Iglesias‐García, Julio , Garg, Pramod, Gulbinas, Antanas , Hyun, Jong Jin , Jonas, Eduard , Kiriukova, Mariia A. , Laukkarinen, Johanna , Loveček, Martin , Molven, Anders , Nosáková, Lenka , Obmann, Verena Carola , Papachristou, Georgios I. , Peláez‐Luna, Mario , Robinson, Stuart Michael , Smits, Mark M. , Tacelli, Matteo , Teutsch, Brigitta , Udrescu, Mihaela, Yavas, Aslihan , Zamboni, Giulia Angela, Löhr, J.-Matthias
United European Gastroenterology Journal | February 14, 2026 | Volume: 14 | Issue: 1 | Pages: No page available
ABSTRACT This international, multidisciplinary consensus report represents the first effort to systematically define and characterize fatty pancreas. A key outcome of this endeavor was the recommendation to adopt “fatty pancreas” as the standardized and inclusive term to describe all forms of fat accumulation in the pancreas. This terminological consensus provides a critical foundation for unified reporting and clinical communication. Another major contribution of the report is the consensus on diagnostic imaging findings, which was based on radiological and endoscopic modalities. The proposed criteria aim to enhance consistency in clinical assessment and support the development of standardized research protocols. In addition to establishing terminology and diagnostic frameworks, the report also synthesizes current knowledge across a wide range of relevant domains. These include the etiology and epidemiology of fatty pancreas, as well as its associations with alcohol consumption, smoking, acute and chronic pancreatitis, pancreatic exocrine insufficiency, type 2 diabetes mellitus, and surgical outcomes. The potential links between fatty pancreas and neoplastic conditions such as intraductal papillary mucinous neoplasms and pancreatic cancer are also addressed, alongside the current understanding of its metabolic implications (beta‐cell function and glucose homeostasis) and treatment strategies. Throughout the consensus process, a consistent theme emerged: the limited availability of high‐quality, prospective clinical data. Therefore, many of the recommendations in this report are based on expert consensus rather than strong empirical evidence. As such, the statements require rigorous prospective validation before they can be adopted into routine clinical practice. This underscores a critical need for further research, particularly studies aimed at clarifying causal relationships, validating diagnostic tools, and determining the clinical relevance of fatty pancreas across diverse patient populations. This report serves as both a summary of our current understanding and a roadmap for future investigations, aiming to close existing knowledge gaps and guide evidence‐based clinical practice in this emerging field.