Letter to the Editor: Beyond cyst size - a time-risk-state framework for dynamic surveillance de-escalation of branch duct intraductal papillary mucinous neoplasms

doi:10.5306/wjco.123540

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World Journal of Clinical Oncology

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2218-4333

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Oncol. Jul 24, 2026; 17(7): 123540
Published online Jul 24, 2026. doi: 10.5306/wjco.123540

Letter to the Editor: Beyond cyst size - a time-risk-state framework for dynamic surveillance de-escalation of branch duct intraductal papillary mucinous neoplasms

Chun-Xiao Ni, Jia-Ju Xu

Jia-Ju Xu, Department of Medical Oncology, Tai’an City Central Hospital, Tai’an 271000, Shandong Province, China

Chun-Xiao Ni, Department of Minimally Invasive Oncology, Tai’an City Central Hospital, Tai’an 271000, Shandong Province, China

Co-first authors: Jia-Ju Xu and Chun-Xiao Ni.

Author contributions: Xu JJ was responsible for the conceptualization, methodology, and supervision; Xu JJ and Ni CX performed the writing, editing, and literature review; Both authors approved the final version. Xu JJ and Ni CX contributed equally to this work as co-first authors.

AI contribution statement: DeepSeek was used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Jia-Ju Xu, MD, Department of Medical Oncology, Tai’an City Central Hospital, No. 29 Longtan Road, Tai’an 271000, Shandong Province, China. jiajuxu1101@163.com

Received: May 25, 2026
Revised: July 10, 2026
Accepted: July 15, 2026
Published online: July 24, 2026
Processing time: 64 Days and 17.4 Hours

Core Tip

Core Tip: This letter proposes a three-dimensional dynamic surveillance de-escalation framework for branch duct intraductal papillary mucinous neoplasms. After 2 years of stability, patients with a cyst size < 30 mm and a serum carbohydrate antigen 19-9 level < 43 kU/L can safely transition from intensive tumor screening to chronic disease-style follow-up aimed at preventing overtreatment.