Intraductal papillary mucinous neoplasms: does a family history of pancreatic cancer matter?
OBJECTIVE
The purpose of this study is to compare surgically resected intraductal papillary mucinous neoplasms (IPMNs) in patients with and without a family history of pancreatic cancer to gain insight into differences that may suggest the need for differential management.


METHODS
A retrospective review of patients who underwent resection of an IPMN at the Massachusetts General Hospital (1990-2011) was conducted. Three hundred and twenty-four patients of whom 45 (13.9%) had a family history of pancreatic cancer were identified. Patients with (PFH) and without (NFH) a family history of pancreatic cancer were compared.


RESULTS
There were no differences in demographic characteristics between groups. Extra-pancreatic malignancies diagnosed prior to the IPMN were more common in those with a PFH (35.6% vs 20.1%, p = 0.03). There were no differences in IPMN characteristics between groups including no difference in the presence of invasive disease (p = 0.55). Concurrent pancreatic ductal adenocarcinomas were more common in those with a PFH (11.1% vs 2.9%, p = 0.02). The survival in the PFH group was marginally lower than the NFH group, a difference found to be attributable to the higher prevalence of extra-pancreatic malignancies.


CONCLUSIONS
Characteristics of surgically resected IPMNs are not different between patients with and without a family history of pancreatic cancer. Most importantly, the incidence of invasive disease is not different, suggesting that these lesions may not be more aggressive when they occur in the presence of a family history of pancreatic cancer.
Department of Surgery, Massachusetts General Hospital, Boston MA, USA.
Deepika
D
Nehra
Vicente Morales
VM
Oyarvide
Mari
M
Mino-Kenudson
Sarah P
SP
Thayer
Cristina R
CR
Ferrone
Jennifer A
JA
Wargo
Alona
A
Muzikansky
Dianne
D
Finkelstein
Andrew L
AL
Warshaw
Carlos Fernández-del
CF
Castillo
D002288:Adenocarcinoma, Mucinous / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D012907:Smoking / Q000453:epidemiology; D015996:Survival Rate