title: Management strategy for multifocal branch duct intraductal papillary mucinous neoplasms of the pancreas.
abstract: OBJECTIVE
  Branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMNs) often are composed of multifocal lesions. We aimed to clarify the clinicopathologic features of multifocal BD-IPMNs.
  
  
  METHODS
  Medical records of 211 patients with BD-IPMNs (169 solitary and 42 multifocal) were retrospectively analyzed. We compared the pathological grade of resected IPMNs and the resulting clinical course between solitary and multifocal BD-IPMNs.
  
  
  RESULTS
  Sixty-nine patients (54 with solitary and 15 with multifocal BD-IPMNs) underwent pancreatectomy, and of these patients, 62 exhibited at least 1 malignant predictor. There was no significant difference in the prevalence of malignancy in the resected BD-IPMNs between the 2 groups. In the remaining 142 patients who exhibited no malignant predictors, both groups demonstrated no differences in morphologic changes of BD-IPMNs. Seventeen distinct ductal carcinomas were identified in both groups, and there was no difference in the prevalence of ductal carcinoma between the 2 groups. Moreover, there was no significant difference in the disease-specific survival rate between the 2 groups.
  
  
  CONCLUSIONS
  In patients with multifocal BD-IPMNs, resection is only warranted for lesions that exhibit malignancy predictors; moreover, closer attention to the potential presence or development of distinct ductal carcinoma in patients with multifocal and solitary BD-IPMNs is warranted.
authors: Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Yasuhisa
authors: Y
authors: Mori
authors: Takao
authors: T
authors: Ohtsuka
authors: Hiroshi
authors: H
authors: Kono
authors: Noboru
authors: N
authors: Ideno
authors: Teppei
authors: T
authors: Aso
authors: Yosuke
authors: Y
authors: Nagayoshi
authors: Shunichi
authors: S
authors: Takahata
authors: Masafumi
authors: M
authors: Nakamura
authors: Kousei
authors: K
authors: Ishigami
authors: Shinichi
authors: S
authors: Aishima
authors: Yoshinao
authors: Y
authors: Oda
authors: Masao
authors: M
authors: Tanaka
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome