Publication Name	World Journal of Clinical Oncology
Manuscript ID	123540
DOI	10.5306/wjco.123540
Country	China

Category	Oncology
Manuscript Type	Correspondence
Article Title	Letter to the Editor: Beyond cyst size - a time-risk-state framework for dynamic surveillance de-escalation of branch duct intraductal papillary mucinous neoplasms
Manuscript Source	Unsolicited Manuscript
All Author List	Jia-Ju Xu and Chun-Xiao Ni
Funding Agency and Grant Number
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
Key Words	Branch duct intraductal papillary mucinous neoplasm; Surveillance de-escalation; Risk stratification; Time risk state framework; Patient-centeredness; Overtreatment
Core Tip	This letter proposes a three-dimensional dynamic surveillance de-escalation framework for branch duct intraductal papillary mucinous neoplasms. After two 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.
Citation	Xu JJ, Ni CX. Letter to the Editor: Beyond cyst size - a time-risk-state framework for dynamic surveillance de-escalation of branch duct intraductal papillary mucinous neoplasms. World J Clin Oncol 2026; In press DOI: https://doi.org/10.5306/wjco.123540
PDF	123540-in-press.pdf

Received	2026-05-25 07:27
Peer-Review Started	2026-05-25 07:27
First Decision by Editorial Office Director
Return for Revision	2026-07-06 06:23
Revised	2026-07-10 06:55
Publication Fee Transferred
Second Decision by Editor	2026-07-15 02:52
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-07-15 07:55
Articles in Press	2026-07-15 07:55
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2218-4333 (online)
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