title: Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery?
abstract: BACKGROUND
  Despite recently increasing numbers of reports on intraductal papillary mucinous tumors (IPMTs), difficulties still remain in terms of diagnosis, treatment, and prognosis. The purpose of this multicenter study was to evaluate the clinicopathologic features of IPMT in Korea and to suggest predictive criteria for malignancy in IPMT.
  
  
  METHODS
  We retrospectively reviewed the clinicopathologic data of 208 patients who underwent operations for IPMT between 1993 and 2002 at 28 institutes in Korea.
  
  
  RESULTS
  Of the 208 patients (mean age, 61 years), 147 were men and 61 were women. A total of 124 patients underwent pancreatoduodenectomy, 42 underwent distal pancreatectomy, 17 underwent total pancreatectomy, and 25 underwent limited pancreatic resection. There were 128 benign cases (adenoma, n = 62; borderline, n = 66) and 80 malignant cases (noninvasive, n = 29; invasive, n = 51). A significant difference in 5-year survival was observed between the benign and malignant groups (92.6% vs. 65.3%; P = .006). Of the six factors (age, location, duct dilatation, mural nodule, main duct type, and tumor size) that showed statistical differences by univariate analysis between the benign and malignant groups, three were significant by multivariate analysis--namely, mural nodule (P = .009), tumor size (P = .023), and a dilated duct size (P = .010).
  
  
  CONCLUSIONS
  A significant proportion of IPMTs are malignant, although the overall prognosis of IPMT is superior to that of ordinary pancreatic cancer. Radical surgery is recommended for IPMT with the predictors of malignancy: mural nodule, tumor size (> or =30 mm), and dilated duct size (> or =12 mm).
authors.affiliation: Department of Surgery, Seoul National University Hospital, 28 Yongon-dong, Changno-gu, 110-744 Seoul, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Ahn
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Min Gew
authors.initials: MG
authors.lastname: Choi
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Woo Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Song Chul
authors.initials: SC
authors.lastname: Kim
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Baik Hwan
authors.initials: BH
authors.lastname: Cho
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Yu
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Kyung Bum
authors.initials: KB
authors.lastname: Lee
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Myung-Wook
authors.initials: MW
authors.lastname: Kim
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Yong-Hyun
authors.initials: YH
authors.lastname: Park
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology*; D016577:Pancreaticoduodenectomy; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis