BACKGROUND/AIMS: Intraductal papillary mucinous tumors of the pancreas have been recognized as a distinct clinical entity. However, their biological behavior has not been clearly defined. The aim of this study was to examine the prognosis of this tumor, to clarify the biological behavior and determine the most appropriate treatment. METHODOLOGY: Correlations between prognosis of operated cases and histopathologic features were investigated. RESULTS: In 105 patients with characteristic clinical features of intraductal papillary mucinous tumors, the lesions were classified as hyperplasias in 21%, intraductal tumors in 48% and invasive carcinomas in 31%. Minimal invasion was apparent in 25%, lymph node metastasis in 21%, and fistula formation in 31% of the invasive lesions. Non-invasive and minimally invasive intraductal papillary mucinous tumors were essentially free from risk of tumor recurrence. Other invasive intraductal papillary mucinous tumors showed a significantly poor prognosis. CONCLUSIONS: Because of the variation in pathological characteristics, patient outcome and the possibility of differential diagnosis, the treatment might be recommended as follows: the case of hyperplasia can be followed-up with close surveillance. Non-invasive and minimally invasive intraductal papillary mucinous tumors should be operated with function-preserving minimal pancreatectomy. For patients with invasive intraductal papillary mucinous tumors evident with preoperative imaging modalities, radical operations with lymph node dissection might be needed.
BACKGROUND/AIMS: Intraductal papillary mucinous tumors of the pancreas have been recognized as a distinct clinical entity. However, their biological behavior has not been clearly defined. The aim of this study was to examine the prognosis of this tumor, to clarify the biological behavior and determine the most appropriate treatment. METHODOLOGY: Correlations between prognosis of operated cases and histopathologic features were investigated. RESULTS: In 105 patients with characteristic clinical features of intraductal papillary mucinous tumors, the lesions were classified as hyperplasias in 21%, intraductal tumors in 48% and invasive carcinomas in 31%. Minimal invasion was apparent in 25%, lymph node metastasis in 21%, and fistula formation in 31% of the invasive lesions. Non-invasive and minimally invasive intraductal papillary mucinous tumors were essentially free from risk of tumor recurrence. Other invasive intraductal papillary mucinous tumors showed a significantly poor prognosis. CONCLUSIONS: Because of the variation in pathological characteristics, patient outcome and the possibility of differential diagnosis, the treatment might be recommended as follows: the case of hyperplasia can be followed-up with close surveillance. Non-invasive and minimally invasive intraductal papillary mucinous tumors should be operated with function-preserving minimal pancreatectomy. For patients with invasive intraductal papillary mucinous tumors evident with preoperative imaging modalities, radical operations with lymph node dissection might be needed.
Authors: Anne Couvelard; Alain Sauvanet; Reza Kianmanesh; Pascal Hammel; Nathalie Colnot; Philippe Lévy; Philippe Ruszniewski; Pierre Bedossa; Jacques Belghiti Journal: Ann Surg Date: 2005-12 Impact factor: 12.969
Authors: Joshua A Waters; C Max Schmidt; Jason W Pinchot; Patrick B White; Oscar W Cummings; Henry A Pitt; Kumar Sandrasegaran; Fatih Akisik; Thomas J Howard; Attila Nakeeb; Nicholas J Zyromski; Keith D Lillemoe Journal: J Gastrointest Surg Date: 2007-10-05 Impact factor: 3.452
Authors: Frank Schönleben; Wanglong Qiu; Helen E Remotti; Werner Hohenberger; Gloria H Su Journal: Langenbecks Arch Surg Date: 2008-02-21 Impact factor: 3.445
Authors: Dirk Bausch; Mari Mino-Kenudson; Carlos Fernández-Del Castillo; Andrew L Warshaw; Kimberly A Kelly; Sarah P Thayer Journal: J Gastrointest Surg Date: 2009-09-17 Impact factor: 3.452