title: Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas.
abstract: OBJECTIVE
  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.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA. chari.suresh@mayo.edu
authors.forename: Suresh T
authors.initials: ST
authors.lastname: Chari
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Yadav
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Smyrk
authors.forename: Eugene P
authors.initials: EP
authors.lastname: DiMagno
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Miller
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Clain
authors.forename: Ian A
authors.initials: IA
authors.lastname: Norton
authors.forename: Randall K
authors.initials: RK
authors.lastname: Pearson
authors.forename: Bret T
authors.initials: BT
authors.lastname: Petersen
authors.forename: Maurits J
authors.initials: MJ
authors.lastname: Wiersema
authors.forename: Michael B
authors.initials: MB
authors.lastname: Farnell
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sarr
mesh_terms: D002288:Adenocarcinoma, Mucinous; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors