Intraductal papillary mucinous neoplasms of the pancreas: An analysis of clinicopathologic features and outcome Journal Article

   

Authors:	D'Angelica, M.; Brennan, M. F.; Suriawinata, A. A.; Klimstra, D.; Conlon, K. C.
Article Title:	Intraductal papillary mucinous neoplasms of the pancreas: An analysis of clinicopathologic features and outcome
Abstract:	Objective: To define the natural history of resected intraductal papillary mucinous neoplasms (IPMN) of the pancreas and to identify clinical and pathologic prognostic features. Summary Background Data: IPMN of the pancreas is a recently described pancreatic tumor. Because of a limited number of cases, prognostic factors and the natural history of resected cases have not been well defined. Materials and Methods: A prospective pancreatic database was reviewed to identify patients with IPMN who were surgically managed. Pathologic re-review of each case was performed, and the clinicopathologic features were examined. Log rank and χ2 analysis were used to identify factors predictive of survival and recurrence. Results: Over a 17-year period, 63 patients were identified. One patient was unresectable, 6 (10%) underwent a total pancreatectomy, and 56 (89%) had a partial pancreatectomy. Invasive carcinoma was present in 30 patients (48%). Transection margins were involved with atypia or carcinoma in 32 patients (51%). The median follow-up for survivors was 38 months. Disease-specific 5- and 10-year survival were 75% and 60%, respectively. Significant predictors of poor outcome included presentation with elevated bilirubin, presence of invasive carcinoma, increasing size and percentage of invasive carcinoma, histologic type of invasive carcinoma, positive lymph nodes, and vascular invasion. The presence of atypia or carcinoma in situ at the ductal resection margin was not associated with a poor outcome. Conclusions: Overall, IPMN has a favorable prognosis. Poor outcome in a subset of patients is largely the result of the presence, extent, and type of an invasive component, lymph node metastases, and vascular invasion.
Keywords:	adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; survival rate; major clinical study; histopathology; cancer recurrence; pancreas resection; pancreatic neoplasms; lymph node metastasis; prospective study; prospective studies; neoplasm recurrence, local; tumor volume; adenocarcinoma, mucinous; carcinoma, papillary; cancer invasion; bilirubin; carcinoma in situ; pancreas tumor; invasive carcinoma; papilloma; mucinous carcinoma; humans; prognosis; human; male; female; priority journal; article
Journal Title:	Annals of Surgery
Volume:	239
Issue:	3
ISSN:	0003-4932
Publisher:	Lippincott Williams & Wilkins
Date Published:	2004-03-01
Start Page:	400
End Page:	408
Language:	English
DOI:	10.1097/01.sla.0000114132.47816.dd
PROVIDER:	scopus
PMCID:	PMC1356240
PUBMED:	15075659
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-1242341489&partnerID=40&md5=1e19ae131b607c1583f31b9a3f4ca1a3
Notes:	Ann. Surg. -- Cited By (since 1996):218 -- Export Date: 16 June 2014 -- CODEN: ANSUA -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/53362