title: Synchronous and metachronous extrapancreatic malignant neoplasms in patients with intraductal papillary-mucinous neoplasm of the pancreas.
abstract: OBJECTIVE
  Patients with intraductal papillary-mucinous neoplasm (IPMN) of the pancreas are likely to have a better prognosis than those with conventional pancreatic ductal adenocarcinoma. Recently there have been some reports on extrapancreatic malignant neoplasms (EPM) occurring in patients with IPMN. The purpose of this study was to discover the characteristic features of IPMN with EPM compared with IPMN without EPM.
  
  
  METHODS
  61 patients with IPMN who underwent surgery at Tohoku University Hospital between 1988 and 2006 were retrospectively analyzed.
  
  
  RESULTS
  The 61 patients with IPMN in this study comprised 25 with intraductal papillary-mucinous adenomas (IPMA) and 36 with intraductal papillary-mucinous carcinomas (IPMC) including 6 with invasive carcinomas. Synchronous and metachronous EPM were observed in 15 out of the 61 patients (24.6%). Three of these patients, including 2 with IPMA and 1 with invasive carcinoma associated with IPMC, died of the EPM. None of the features, including sex, age, smoking, family history, macroscopic types (main duct type or branch duct type), histological types (gastric, intestinal, pancreatobiliary or oncocytic), and aberrant expression of molecules including CDKN2A, TP53, SMAD4 and DUSP6, except for the histological diagnoses were associated with the occurrence of EPM, i.e., the EPM occurred more often in patients with IPMA (10 out of 25) than in those with IPMC (5 out of 36) in our series (p = 0.0199 by the chi(2) test, p = 0.0330 by Fisher's exact probability test, p = 0.0422 by Yates' correction).
  
  
  CONCLUSIONS
  Patients with IPMA were more likely to have EPM than those with IPMC. Patients with IPMA are usually expected to have a fair prognosis but EPM could be fatal in some of them, so it must be noted during follow-up.
authors.affiliation: Department of Gastroenterological Surgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishida
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Kei
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aoki
authors.forename: Naoaki
authors.initials: N
authors.lastname: Sakata
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mikami
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Abe
authors.forename: Shoji
authors.initials: S
authors.lastname: Fukuyama
authors.forename: Yu
authors.initials: Y
authors.lastname: Katayose
authors.forename: Makoto
authors.initials: M
authors.lastname: Sunamura
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.forename: Takuya
authors.initials: T
authors.lastname: Moriya
authors.forename: Akira
authors.initials: A
authors.lastname: Horii
authors.forename: Toru
authors.initials: T
authors.lastname: Furukawa
mesh_terms: D000368:Aged; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000556:secondary*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies