BACKGROUND: Since any intraductal papillary mucinous neoplasm (IPMN) is at least premalignant, avoiding conversion to invasion by pancreatic resection should provide a survival advantage-but how much? METHODS: We reviewed 100 cases of IPMN that were resected. Survival was compared between 3 groups: noninvasive IPMN (n = 75), invasive IPMN (n = 25), and invasive ductal adenocarcinoma (n = 24), the latter matched by tumor-node-metastasis (TNM) stage to the IPMN invasive group. RESULTS: The 5-year disease-specific survival was significantly better for the noninvasive IPMN group (100%) than the invasive IPMN group (46%). Tumor recurrence was infrequent with noninvasive IPMNs (1.3% benign IPMN). Recurrence was common in the invasive IPMN group (46%). Even the subgroup with stage 1 disease had a 25% recurrence of malignancy. Survival curves were not different (P = .11) between the cases matched by stage for those with invasive IPMN cases versus cases with ductal adenocarcinoma. CONCLUSION: Patients with the invasive form of IPMN will have a similarly poor survival as those with ductal adenocarcinoma. In patients thought to have a benign IPMN, these lesions should be removed to avoid conversion to invasive cancer and to preserve the opportunity for the more favorable prognosis observed in this study.
BACKGROUND: Since any intraductal papillary mucinous neoplasm (IPMN) is at least premalignant, avoiding conversion to invasion by pancreatic resection should provide a survival advantage-but how much? METHODS: We reviewed 100 cases of IPMN that were resected. Survival was compared between 3 groups: noninvasive IPMN (n = 75), invasive IPMN (n = 25), and invasive ductal adenocarcinoma (n = 24), the latter matched by tumor-node-metastasis (TNM) stage to the IPMN invasive group. RESULTS: The 5-year disease-specific survival was significantly better for the noninvasive IPMN group (100%) than the invasive IPMN group (46%). Tumor recurrence was infrequent with noninvasive IPMNs (1.3% benign IPMN). Recurrence was common in the invasive IPMN group (46%). Even the subgroup with stage 1 disease had a 25% recurrence of malignancy. Survival curves were not different (P = .11) between the cases matched by stage for those with invasive IPMN cases versus cases with ductal adenocarcinoma. CONCLUSION:Patients with the invasive form of IPMN will have a similarly poor survival as those with ductal adenocarcinoma. In patients thought to have a benign IPMN, these lesions should be removed to avoid conversion to invasive cancer and to preserve the opportunity for the more favorable prognosis observed in this study.
Authors: Olivier Turrini; Joshua A Waters; Thomas Schnelldorfer; Keith D Lillemoe; Constantin T Yiannoutsos; Michael B Farnell; Michael G Sarr; C Max Schmidt Journal: HPB (Oxford) Date: 2010-09 Impact factor: 3.647
Authors: Kaye M Reid-Lombardo; Jennifer St Sauver; Zhuo Li; William A Ahrens; K Krishnan Unni; Florencia G Que Journal: Pancreas Date: 2008-08 Impact factor: 3.327
Authors: George A Poultsides; Sushanth Reddy; John L Cameron; Ralph H Hruban; Timothy M Pawlik; Nita Ahuja; Ajay Jain; Barish H Edil; Christine A Iacobuzio-Donahue; Richard D Schulick; Christopher L Wolfgang Journal: Ann Surg Date: 2010-03 Impact factor: 12.969
Authors: Courtney J Pokrzywa; Daniel E Abbott; Kristina A Matkowskyj; Sean M Ronnekleiv-Kelly; Emily R Winslow; Sharon M Weber; Alexander V Fisher Journal: J Gastrointest Surg Date: 2019-01-31 Impact factor: 3.452