Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms Journal Article
| Authors: | Frankel, T. L.; LaFemina, J.; Bamboat, Z. M.; D'Angelica, M. I.; DeMatteo, R. P.; Fong, Y.; Kingham, T. P.; Jarnagin, W. R.; Allen, P. J. |
| Article Title: | Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms |
| Abstract: | Background The significance of a positive margin in resected non-invasive pancreatic intraductal papillary mucinous neoplasms (IPMN) remains controversial. The aim of this study was to determine recurrence rates when dysplasia was present at the final surgical margin. Methods A prospectively maintained database identified 192 patients undergoing resection of non-invasive IPMN. Pathological, peri-operative and recurrence data were analysed. Results Ductal dysplasia was identified at the final surgical margin in 86 patients (45%) and defined as IPMN or Pancreatic Intraepithelial Neoplasia PanIN in 38 (20%) and 54 (28%) patients, respectively. At a median follow-up of 46 months, 40 (21%) patients recurred with 31 developing radiographical evidence of new cysts, 6 re-resected for IPMN and 3 diagnosed with pancreatic cancer within the remnant. Of those with margin dysplasia, 31% developed recurrent disease compared with 13% in those without dysplasia (P = 0.002). On multivariate analysis, margin dysplasia was associated with a three-fold increased risk of recurrence (P = 0.02). No relationship between dysplasia and development of pancreatic cancer was found. Discussion In this study, dysplasia at the margin after a pancreatectomy for non-invasive IPMN was associated with recurrence in the remnant gland, but not at the resection margin. While this finding may warrant closer follow-up, it does not identify a gland at higher risk for the subsequent development of invasive disease. © 2013 International Hepato-Pancreato-Biliary Association. |
| Journal Title: | HPB |
| Volume: | 15 |
| Issue: | 10 |
| ISSN: | 1365-182X |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2013-10-01 |
| Start Page: | 814 |
| End Page: | 821 |
| Language: | English |
| DOI: | 10.1111/hpb.12137 |
| PROVIDER: | scopus |
| PUBMED: | 23782351 |
| PMCID: | PMC3791121 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "CODEN: HPBIF" - "Source: Scopus" |
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