title: Mucin-producing neoplasms of the pancreas: an analysis of distinguishing clinical and epidemiologic characteristics.
abstract: OBJECTIVE
  Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics.
  
  
  METHODS
  Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified.
  
  
  RESULTS
  One hundred sixty-eight patients (30%) had MCNs, 159 (28.5%) had branch-duct IPMNs, 149 (27%) had combined IPMNs, and 81 (14.5%) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44% of patients with main-duct or combined IPMNs and 57% of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95%); 11% were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11%, 42%, and 48% of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100% for patients with noninvasive MPNs. The rates for those with invasive cancer were 58%, 56%, 51%, and 64% for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively.
  
  
  CONCLUSIONS
  MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.
authors.affiliation: Department of Surgery, Policlinico GB Rossi, University of Verona, Verona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Crippa
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Del Castillo
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Dianne
authors.initials: D
authors.lastname: Finkelstein
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Ismael
authors.initials: I
authors.lastname: Domínguez
authors.forename: Alona
authors.initials: A
authors.lastname: Muzikansky
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Thayer
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
authors.forename: Mari
authors.initials: M
authors.lastname: Mino-Kenudson
authors.forename: Paola
authors.initials: P
authors.lastname: Capelli
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: Stefano
authors.initials: S
authors.lastname: Partelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Pederzoli
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Warshaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000453:epidemiology* / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000473:pathology*
chemical_list: D009077:Mucins