title: Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas.
abstract: BACKGROUND
  Frequency and characteristics of metachronous occurrence of multifocal intraductal papillary mucinous neoplasms (IPMNs) or distinct pancreatic ductal adenocarcinomas (PDACs) in the remnant pancreas during follow-up evaluation after pancreatectomy for IPMNs have not been well known. The aim of this study was to investigate the outcomes after resection of IPMNs, especially focusing on the metachronous occurrence of multifocal IPMNs and distinct PDACs.
  
  
  METHODS
  Medical records of 172 patients who underwent resection of IPMNs were reviewed retrospectively, and the data regarding the occurrence of metachronous IPMNs or PDACs in the remnant pancreas during a mean postoperative follow-up period of 64 months were collected.
  
  
  RESULTS
  The incidence including synchronous and metachronous multifocal occurrence of IPMNs was 20% (34 of 172), and that of distinct PDACs was 9.9% (17 of 172). Ten metachronous IPMNs developed in the remnant pancreas after a mean time of 23 postoperative months (range, 12-84 mo), and 2 with main duct IPMNs (both were carcinoma in situ) required remnant pancreatectomy. Six distinct PDACs developed in the remnant pancreas after a mean time of 84 postoperative months (range, 12-150 mo). Four of them were found to have a tumor with a size of less than 2 cm, whereas the remaining 2 PDACs were found to be unresectable more than 10 years after resection of IPMNs.
  
  
  CONCLUSIONS
  Intense long-term follow-up evaluation is necessary for the early detection of metachronous occurrence of distinct PDACs as well as malignant IPMNs after resection of IPMNs.
authors: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.
authors: Takao
authors: T
authors: Ohtsuka
authors: Hiroshi
authors: H
authors: Kono
authors: Reiko
authors: R
authors: Tanabe
authors: Yosuke
authors: Y
authors: Nagayoshi
authors: Yasuhisa
authors: Y
authors: Mori
authors: Yoshihiko
authors: Y
authors: Sadakari
authors: Shunichi
authors: S
authors: Takahata
authors: Yasunori
authors: Y
authors: Oda
authors: Shinichi
authors: S
authors: Aishima
authors: Hisato
authors: H
authors: Igarashi
authors: Tetsuhide
authors: T
authors: Ito
authors: Kousei
authors: K
authors: Ishigami
authors: Masafumi
authors: M
authors: Nakamura
authors: Kazuhiro
authors: K
authors: Mizumoto
authors: Masao
authors: M
authors: Tanaka
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000601:surgery*; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D011159:Population Surveillance; D012189:Retrospective Studies; D013997:Time Factors