Invasive carcinoma derived from intraductal papillary mucinous carcinoma of the pancreas.
OBJECTIVE
Most patients with intraductal papillary mucinous tumors of the pancreas have a favorable prognosis after surgical treatment. However, recurrent disease frequently occurs in patients with invasive carcinoma derived from intraductal papillary mucinous carcinoma. The objective of this study was to clarify the clinicopathological features of invasive carcinoma derived from intraductal papillary mucinous carcinoma.


METHODS
We performed a retrospective review of the 29 patients with intraductal papillary mucinous tumor including 10 patients with invasive carcinoma who underwent pancreatic resection between June 1995 and December 2001 at the National Cancer Center Hospital East.


RESULTS
Of 10 patients with invasive carcinoma derived from intraductal papillary mucinous carcinoma, 7 patients had lymph node involvement and 8 patients had retroperitoneal invasion. The overall 1-, 2-, 4-year actuarial survival rate for invasive carcinoma derived from intraductal papillary mucinous carcinoma was 39%, 26%, 13%. Recurrence occurred as liver metastasis in 3 patients, carcinomatous peritonitis in 3, local recurrence in 3, and lung metastasis in 1. All patients with adenoma, non-invasive carcinoma, and minimally invasive carcinoma are alive without recurrent disease after pancreatic resection.


CONCLUSIONS
Patients with invasive carcinoma derived from intraductal papillary mucinous carcinoma had a worse prognosis. Margin-negative pancreatic resection is essential for treating this disease.
Nakagohri
Toshio
T
Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan. tnakagor@east.ncc.go.jp
Konishi
Masaru
M
Inoue
Kazuto
K
Tanizawa
Yutaka
Y
Kinoshita
Taira
T
D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D015996:Survival Rate