title: Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN.
abstract: OBJECTIVE
  Pancreatic ductal adenocarcinoma (PDAC) may derive from an intraductal papillary mucinous neoplasm (IPMN) of the pancreas or may develop in the pancreatic duct apart from IPMN. The purpose of this study was to define the clinicopathological features of these 2 entities and compare them with those of ordinary PDAC.
  
  
  METHODS
  Of 765 patients who had surgical resection for IPMN, 122 were diagnosed as having PDAC derived from IPMN and 31 with PDAC concomitant with IPMN. In addition, 7605 patients with PDAC who were registered in the Japan Pancreas Society pancreatic cancer registry were compared with the above patients.
  
  
  RESULTS
  Pancreatic ductal adenocarcinomas derived from IPMN and concomitant with IPMN were significantly smaller, less invasive, and less extensive than ordinary PDAC. The median survival of patients with the 2 conditions was significantly longer than for those with ordinary PDAC when compared overall or when limited to TS2 (2.0 cm < tumor size ≤ 4.0 cm) or TS3 (4.0 cm < tumor size ≤ 6.0 cm) cases.
  
  
  CONCLUSIONS
  These findings suggest that PDAC concomitant with IPMN and PDAC derived from IPMN may have more favorable biological behaviors or be diagnosed earlier than ordinary PDAC.
authors.affiliation: Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. yamaguch@med.uoeh-u.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kanemitsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Hatori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.forename: Manabu
authors.initials: M
authors.lastname: Osanai
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Noda
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nakaizumi
authors.forename: Toru
authors.initials: T
authors.lastname: Furukawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ban
authors.forename: Bunsei
authors.initials: B
authors.lastname: Nobukawa
authors.forename: Yo
authors.initials: Y
authors.lastname: Kato
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology*; D005260:Female; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012042:Registries / Q000706:statistics & numerical data; D016019:Survival Analysis