title: Intraductal papillary mucinous neoplasms of the pancreas: clinicopathological features and long term outcome related to histopathological group.
abstract: OBJECTIVE
  To investigate the clinicopathological features of intraductal papillary mucinous neoplasms and evaluate the prognosis between histopathological groups.
  
  
  METHODS
  Retrospective review of 55 consecutive patients operated between 1991 and 2006, analysis of clinicopathological features and survival.
  
  
  RESULTS
  Group I comprised of 9 mild and 14 moderate dysplasias, group II of 11 carcinomas in situ and group III of 21 invasive cancers. Age, diabetes, anorexia and jaundice were significantly more frequent in group III. Thirty-two patients (58.2%) presented main duct type which was more frequently associated with invasive carcinoma. Mean tumoral size progress from group I to group III (26.1mm vs. 27.4mm vs. 32.0mm p=0.015) as the mean size of the pancreatic duct (6.7mm vs. 7.9mm vs. 11.5mm p=0.008). Median follow-up was 154 months with 5-year survival rate of 60.7 %. For group I, II and III it was 76.3 %, 100 % and 25.8 % respectively (p=0.00007). Lymph node positivity was associated with poor outcome: 44.1% vs. 0% (N0 vs. N+) (p=0.0019).
  
  
  CONCLUSIONS
  The prognosis of non-invasive intraductal papillary mucinous neoplasms of the pancreas is favourable. For patients with invasive cancer, nodal invasion is a factor of worst prognosis.
authors.affiliation: Medicosurgical Department of Gastroenterology, ULB Erasme Hospital, Brussels, Belgium.
authors.forename: Véronique
authors.initials: V
authors.lastname: De Moor
authors.forename: Mariana
authors.initials: M
authors.lastname: Arvanitakis
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nagy
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coppens
authors.forename: Myriam
authors.initials: M
authors.lastname: Delhaye
authors.forename: Jean
authors.initials: J
authors.lastname: Closset
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden