Clinicopathologic features of re-resected cases of intraductal papillary mucinous neoplasms (IPMNs).
BACKGROUND
We analyzed the clinical characteristics and patterns of recurrence of intraductal papillary mucinous neoplasms (IPMNs) from 100 consecutive surgical cases.


METHODS
The average age was 62 +/- 12 years. The tumor was located in the head in 65 patients, body in 25 patients, and tail in 10 patients. Sixty-seven patients had benign IPMNs, and 33 patients had malignant IPMNs. Malignant IPMNs were observed more frequently in the head (42%) as compared with the body (20%) or tail (10%) (P < .05). During the follow-up period, 5 patients recurred and underwent second operation. In the first operation, 1 patient underwent pancreatoduodenectomy for the head tumor and the other 4 patients underwent distal pancreatectomy for the body and/or tail tumor.


RESULTS
Although histopathologic findings in the first operation were adenoma in 2 and carcinoma in 3 patients, all patients developed carcinoma by the time of the second operation. No hyperplasia developed recurrence. The overall recurrence rate for the head tumors was 1.5% (1 out of 65), whereas that for the body and tail tumors was 11.4% (4 out of 35) (P < .05). Metachronous multicentric recurrence was suspected in 4 cases.


CONCLUSIONS
These results indicate that adenomatous or carcinomatous IPMNs, especially originated from the body or tail, should be carefully observed even with a histologically negative surgical margin.
Yokoyama
Yukihiro
Y
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Japan. yyoko@med.nagoya-u.ac.jp
Nagino
Masato
M
Oda
Koji
K
Nishio
Hideki
H
Ebata
Tomoki
T
Abe
Tetsuya
T
Igami
Tsuyoshi
T
Nimura
Yuji
Y
D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate