BACKGROUND & AIMS: The aim of this study was to determine recurrence and long-term survival after resection of pancreatic intraductal papillary mucinous neoplasm and to correlate recurrence and survival with histology, extent of resection, and duration of follow-up. METHODS: A single pathologist, without knowledge of previous interpretations of histology or clinical data, retrospectively reviewed and classified 113 resected intraductal papillary mucinous neoplasms as invasive carcinoma (n = 40) or as noninvasive neoplasms (adenoma, borderline, or carcinoma in situ; n = 73). Data on recurrence (locoregional or metastatic), follow-up, and cause of death were obtained from patient records and/or by contacting patients and their physicians. RESULTS: In invasive intraductal papillary mucinous neoplasm, recurrence was similar after partial pancreatectomy (18/27; 67%) and total pancreatectomy (8/13; 62%) and occurred within 3 years of resection in 91%. Among noninvasive neoplasms, 5 of 60 (8%) recurred after partial pancreatectomy (median follow-up, 37 months); none recurred after total pancreatectomy (n = 13; median follow-up, 32 months). Recurrence after resection in noninvasive neoplasms was diagnosed after a median of 40 months (range, 23-75 months); recurrence was noninvasive in 3 and invasive cancer in 2. Five-year survival was better for noninvasive compared with invasive intraductal papillary mucinous neoplasm (84.5% vs. 36%; P < 0.001). CONCLUSIONS: Invasive intraductal papillary mucinous neoplasm recurs frequently even after a complete "curative" resection and portends poor survival. In contrast, noninvasive intraductal papillary mucinous neoplasm recurs infrequently after resection, and survival is excellent regardless of the degree of epithelial dysplasia in the tumor.
BACKGROUND & AIMS: The aim of this study was to determine recurrence and long-term survival after resection of pancreatic intraductal papillary mucinous neoplasm and to correlate recurrence and survival with histology, extent of resection, and duration of follow-up. METHODS: A single pathologist, without knowledge of previous interpretations of histology or clinical data, retrospectively reviewed and classified 113 resected intraductal papillary mucinous neoplasms as invasive carcinoma (n = 40) or as noninvasive neoplasms (adenoma, borderline, or carcinoma in situ; n = 73). Data on recurrence (locoregional or metastatic), follow-up, and cause of death were obtained from patient records and/or by contacting patients and their physicians. RESULTS: In invasive intraductal papillary mucinous neoplasm, recurrence was similar after partial pancreatectomy (18/27; 67%) and total pancreatectomy (8/13; 62%) and occurred within 3 years of resection in 91%. Among noninvasive neoplasms, 5 of 60 (8%) recurred after partial pancreatectomy (median follow-up, 37 months); none recurred after total pancreatectomy (n = 13; median follow-up, 32 months). Recurrence after resection in noninvasive neoplasms was diagnosed after a median of 40 months (range, 23-75 months); recurrence was noninvasive in 3 and invasive cancer in 2. Five-year survival was better for noninvasive compared with invasive intraductal papillary mucinous neoplasm (84.5% vs. 36%; P < 0.001). CONCLUSIONS:Invasive intraductal papillary mucinous neoplasm recurs frequently even after a complete "curative" resection and portends poor survival. In contrast, noninvasive intraductal papillary mucinous neoplasm recurs infrequently after resection, and survival is excellent regardless of the degree of epithelial dysplasia in the tumor.
Authors: Hanno Matthaei; Alexis L Norris; Athanasios C Tsiatis; Kelly Olino; Seung-Mo Hong; Marco dal Molin; Michael G Goggins; Marcia Canto; Karen M Horton; Keith D Jackson; Paola Capelli; Giuseppe Zamboni; Laura Bortesi; Toru Furukawa; Shinichi Egawa; Masaharu Ishida; Shigeru Ottomo; Michiaki Unno; Fuyuhiko Motoi; Christopher L Wolfgang; Barish H Edil; John L Cameron; James R Eshleman; Richard D Schulick; Anirban Maitra; Ralph H Hruban Journal: Ann Surg Date: 2012-02 Impact factor: 12.969
Authors: Antonio Pea; Jun Yu; Neda Rezaee; Claudio Luchini; Jin He; Marco Dal Molin; James F Griffin; Helen Fedor; Shahriar Fesharakizadeh; Roberto Salvia; Matthew J Weiss; Claudio Bassi; John L Cameron; Lei Zheng; Aldo Scarpa; Ralph H Hruban; Anne Marie Lennon; Michael Goggins; Christopher L Wolfgang; Laura D Wood Journal: Ann Surg Date: 2017-07 Impact factor: 12.969
Authors: James M Kiely; Attila Nakeeb; Richard A Komorowski; Stuart D Wilson; Henry A Pitt Journal: J Gastrointest Surg Date: 2003-11 Impact factor: 3.452
Authors: Roberto Salvia; Carlos Fernández-del Castillo; Claudio Bassi; Sarah P Thayer; Massimo Falconi; William Mantovani; Paolo Pederzoli; Andrew L Warshaw Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Kristine S Spinelli; Travis E Fromwiller; Roger A Daniel; James M Kiely; Attila Nakeeb; Richard A Komorowski; Stuart D Wilson; Henry A Pitt Journal: Ann Surg Date: 2004-05 Impact factor: 12.969