S M Woo1, J K Ryu, S H Lee, W J Yoon, Y-T Kim, Y B Yoon. 1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Yeongeon-dong, Jongno-gu, Seoul, Korea.
Abstract
BACKGROUND: A consensus conference has recommended close observation of branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) smaller than 30 mm, without symptoms or mural nodules. This study investigated whether these recommendations could be validated in a single-centre experience of BD-IPMNs. METHODS: Some 190 patients with radiological imaging or histological findings consistent with BD-IPMN were enrolled between 1998 and 2005. Those with less than 6 months' follow-up and no histological confirmation were excluded. RESULTS: BD-IPMN was diagnosed by computed tomography and pancreatography in 105 patients and pathologically in 85. Eighteen patients had adenoma, 53 borderline malignancy, five carcinoma in situ and nine invasive carcinoma. Findings associated with malignancy were the presence of radiologically suspicious features (P < 0.001) and a cyst size of at least 30 mm (P = 0.001). Had consensus guidelines been applied, 54 patients would have undergone pancreatic resection, whereas only 28 of these patients actually had a resection; 12 of the latter patients had a malignancy compared with none of the 26 patients who were treated conservatively. CONCLUSION: A simple increase in cyst size is not a reliable predictor of malignancy. Observation is recommended for patients with a BD-IPMN smaller than 30 mm showing no suspicious features on imaging. (c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
BACKGROUND: A consensus conference has recommended close observation of branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) smaller than 30 mm, without symptoms or mural nodules. This study investigated whether these recommendations could be validated in a single-centre experience of BD-IPMNs. METHODS: Some 190 patients with radiological imaging or histological findings consistent with BD-IPMN were enrolled between 1998 and 2005. Those with less than 6 months' follow-up and no histological confirmation were excluded. RESULTS:BD-IPMN was diagnosed by computed tomography and pancreatography in 105 patients and pathologically in 85. Eighteen patients had adenoma, 53 borderline malignancy, five carcinoma in situ and nine invasive carcinoma. Findings associated with malignancy were the presence of radiologically suspicious features (P < 0.001) and a cyst size of at least 30 mm (P = 0.001). Had consensus guidelines been applied, 54 patients would have undergone pancreatic resection, whereas only 28 of these patients actually had a resection; 12 of the latter patients had a malignancy compared with none of the 26 patients who were treated conservatively. CONCLUSION: A simple increase in cyst size is not a reliable predictor of malignancy. Observation is recommended for patients with a BD-IPMN smaller than 30 mm showing no suspicious features on imaging. (c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors: Muriel Genevay; Mari Mino-Kenudson; Kurt Yaeger; Ioannis T Konstantinidis; Cristina R Ferrone; Sarah Thayer; Carlos Fernandez-del Castillo; Dushyant Sahani; Brenna Bounds; David Forcione; William R Brugge; Martha Bishop Pitman Journal: Ann Surg Date: 2011-12 Impact factor: 12.969
Authors: Klaus Sahora; Carlos Fernández-del Castillo; Fei Dong; Giovanni Marchegiani; Sarah P Thayer; Cristina R Ferrone; Dushyant V Sahani; William R Brugge; Andrew L Warshaw; Keith D Lillemoe; Mari Mino-Kenudson Journal: Surgery Date: 2014-07-28 Impact factor: 3.982
Authors: Brian K P Goh; Damien M Y Tan; Mac M F Ho; Tony K H Lim; Alexander Y F Chung; London L P J Ooi Journal: J Gastrointest Surg Date: 2014-03-26 Impact factor: 3.452