title: Extrapancreatic malignancies in patients with intraductal papillary mucinous neoplasm of the pancreas: prevalence, associated factors, and comparison with patients with other pancreatic cystic neoplasms.
abstract: BACKGROUND
  Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is reported to have a high prevalence of extrapancreatic malignancy (EPM). The aims of this study were to evaluate the prevalence and associated factors of EPMs in IPMN patients and to compare these data with those of non-IPMN pancreatic cystic neoplasm (PCN) patients.
  
  
  METHODS
  The study included 385 PCN patients (210 IPMNs and 175 non-IPMNs) diagnosed from 1993 to 2007. PCN types, presence of EPMs, chronological relation of EPMs to PCN diagnosis, and their clinicopathological parameters were analyzed.
  
  
  RESULTS
  The prevalence of EPM was 33.8% for IPMNs and 12.0% for non-IPMN PCNs (P < 0.001). In the majority of patients with EPMs, PCNs were detected while undergoing workup for the EPMs. For IPMNs, age was associated with EPMs [odds ratio (OR) 1.05, P = 0.013]; malignant IPMN showed a borderline inverse association with EPMs (OR 0.50, P = 0.071). Multivariate analysis of entire PCN cohort demonstrated that age at PCN diagnosis (OR 1.05, P < 0.001) was positively associated with EPM; IPMN showed a borderline positive association with EPM (OR 1.88, P = 0.052). Malignant PCN (OR 0.40, P = 0.009) was inversely associated with EPM.
  
  
  CONCLUSIONS
  The EPM prevalence of IPMN patients was 33.8%. Advanced age at IPMN diagnosis was the only factor significantly associated with EPMs in our IPMN cohort. In our PCN cohort, advanced age at PCN diagnosis was associated with malignant PCN and IPMN showed a borderline positive association with EPM.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-744, Korea.
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yoon
authors.forename: Ji Kon
authors.initials: JK
authors.lastname: Ryu
authors.forename: Jun Kyu
authors.initials: JK
authors.lastname: Lee
authors.forename: Sang Myung
authors.initials: SM
authors.lastname: Woo
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Joo Kyung
authors.initials: JK
authors.lastname: Park
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Yoon
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome