Keywords
malignancy, PDAC, MPD, pancreatic ductal adenocarcinoma
PANCREATIC DUCTAL ADENOCARCINOMA
Despite decades of research, pancreatic ductal adenocarcinoma (PDAC) remains the most aggressive solid malignancy with a 5-year survival of only 9% [The revised Fukuoka Guideline recommended that IPMN with “high-risk stigmata” were indicated for surgical resection, while IPMN with “worrisome features” should undergo further evaluations, especially endoscopic ultrasonography (EUS), to determine the optimal therapeutic regimen [However, the preoperative detection of malignant IPMN and the surgical indication are still controversial. Most recommendations from current guidelines are based on low-quality evidence and expert’s consensus, and disagreement is common. For instance, MPD ≥ 10 mm is recommended in the 2012 International Guideline as an indication for surgery, but in the 2013 European Guideline the cutoff value of MPD width is 6 mm [