Surgical experiences of intraductal papillary mucinous neoplasms of the pancreas at a single Japanese institute: characteristics of malignant histology.
OBJECTIVE
Characteristics of intraductal papillary mucinous neoplasms of pancreas (IPMN) have been clarified by a worldwide survey and meeting. However, the malignant behavior or prognosis of the disease is not always uniform.


METHODS
We examined the clinicopathologic demographics, surgical records and outcome according to degree of histologic malignancy in 18 IPMN patients between 1994 and 2006.


RESULTS
Main duct type was observed in 3 patients, branch duct type in 6, and mixed type in 9. Eight of 18 patients (44.4%) had other malignancies, and other synchronous tumors were observed in the adenoma group. CA 19-9 was increased in invasive carcinomas. The size of the main pancreatic duct and cysts were not correlated with degree of malignancy. Mural nodules were more frequently observed in minimally invasive and invasive carcinomas. Segmental resection or observation was selected in the adenoma group; however, combined resection of main vessels was performed in invasive carcinoma groups. Although 3 of 5 patients with invasive carcinomas had a recurrence and poor patient prognosis, recurrence was not observed in other groups.


CONCLUSIONS
Surgical results for IPMN were satisfactory; however, it is necessary to determine the operative indication before the carcinoma becomes invasive as such lesions have a poor prognosis.
Nanashima
Atsushi
A
Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Sumida
Yorihisa
Y
Abo
Takafumi
T
Oikawa
Masahiro
M
Takeshita
Hiroaki
H
Hidaka
Shigekazu
S
Sawai
Terumitsu
T
Yasutake
Toru
T
Kinoshita
Naoe
N
Hayashi
Tomayoshi
T
Nagayasu
Takeshi
T
D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis