title: Risk factors associated with the postoperative recurrence of intraductal papillary mucinous neoplasms of the pancreas.
abstract: OBJECTIVE
  The risk factors correlated with the post-operative recurrence of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are not well established. The aim was to determine the risk factors of recurrence.
  
  
  METHODS
  We reviewed retrospectively the differences of clinicopathologic features between the recurrence and nonrecurrence groups of patients with IPMN who underwent surgical resection and analyzed the recurrence-related factors.
  
  
  RESULTS
  A total of 103 patients were confirmed to have IPMNs. The mean postoperative follow-up was 3.2 years, and the recurrence rate was 12.6%. Recurrent cases (n=13) had the following pathologic grades: adenoma, 1; and invasive carcinoma, 12. The mean postoperative survival was 17.0 months in the recurrence group and 41.4 months in the nonrecurrence group (P<0.001). The independent risk factors of recurrence were invasive carcinoma (P=0.017, hazard ratio=71.79; 95% confidence interval (CI)=2.13-2417.05), elevated carbohydrate antigen 19-9 (P=0.007, hazard ratio=37.97, 95% CI=2.66-542.32), and main location in the pancreatic head (P=0.038, hazard ratio=0.16, 95% CI=0.03-0.90).
  
  
  CONCLUSIONS
  The risk factors associated with recurrence of IPMNs were invasive pathology, elevated carbohydrate antigen 19-9, and main location in the pancreatic head. A more careful follow-up is needed for such patients.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jongwook
authors.initials: J
authors.lastname: Park
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Jang
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Seo
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Kee-Taek
authors.initials: KT
authors.lastname: Jang
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Heo
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018395:CA-19-9 Antigen / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D018395:CA-19-9 Antigen