title: Outcomes following resection of invasive and noninvasive intraductal papillary mucinous neoplasms of the pancreas.
abstract: BACKGROUND
  Since any intraductal papillary mucinous neoplasm (IPMN) is at least premalignant, avoiding conversion to invasion by pancreatic resection should provide a survival advantage-but how much?
  
  
  METHODS
  We reviewed 100 cases of IPMN that were resected. Survival was compared between 3 groups: noninvasive IPMN (n = 75), invasive IPMN (n = 25), and invasive ductal adenocarcinoma (n = 24), the latter matched by tumor-node-metastasis (TNM) stage to the IPMN invasive group.
  
  
  RESULTS
  The 5-year disease-specific survival was significantly better for the noninvasive IPMN group (100%) than the invasive IPMN group (46%). Tumor recurrence was infrequent with noninvasive IPMNs (1.3% benign IPMN). Recurrence was common in the invasive IPMN group (46%). Even the subgroup with stage 1 disease had a 25% recurrence of malignancy. Survival curves were not different (P = .11) between the cases matched by stage for those with invasive IPMN cases versus cases with ductal adenocarcinoma.
  
  
  CONCLUSIONS
  Patients with the invasive form of IPMN will have a similarly poor survival as those with ductal adenocarcinoma. In patients thought to have a benign IPMN, these lesions should be removed to avoid conversion to invasive cancer and to preserve the opportunity for the more favorable prognosis observed in this study.
authors.affiliation: Department of General Surgery, Virginia Mason Medical Center, 1100 Ninth Ave., C6-GSURG, Seattle, WA 98111, USA.
authors.forename: Keita
authors.initials: K
authors.lastname: Wada
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kozarek
authors.forename: L William
authors.initials: LW
authors.lastname: Traverso
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome