title: Is it necessary to follow patients after resection of a benign pancreatic intraductal papillary mucinous neoplasm?
abstract: BACKGROUND
  Little is known about the risk of subsequently developing a new or progressive intraductal papillary mucinous neoplasm (IPMN) after partial pancreatic resection of a noninvasive IPMN.
  
  
  METHODS
  One hundred thirty patients with more than 1 year of follow-up after resection were included in this analysis.
  
  
  RESULTS
  At a median follow-up of 38 months, 22 (17%) developed imaging evidence of a new or progressive IPMN. Eleven (8%) underwent completion resection. Three of the 11 patients had invasive adenocarcinoma. Two other patients developed metastatic pancreatic adenocarcinoma and did not undergo resection. All 5 patients (4%) with cancer had negative margins at initial operation. Sixteen of 100 patients (16%) with negative margins for IPMN at the initial operation developed a new IPMN vs 6 of 30 patients (20%) with margins positive for IPMN (p = ns). Five of 22 patients (23%) with a new IPMN had a family history of pancreatic cancer, while 8 of 108 patients (7%) without a new IPMN had a family history (p < 0.05). Overall, the chances of developing a new IPMN at 1, 5, and 10 years after the initial surgery were 4%, 25%, and 62%, respectively, and of requiring surgery were 1.6%, 14%, and 18%, respectively. The estimated chances of developing invasive pancreatic cancer were 0%, 7%, and 38% at 1, 5, and 10 years, respectively.
  
  
  CONCLUSIONS
  Patients who have undergone resection for noninvasive IPMN require indefinite close surveillance because of the risks of developing a new IPMN, of requiring surgery, and of developing cancer. A family history of pancreatic cancer, but not margin status or degree of dysplasia, is associated with a risk of development of a new or progressive IPMN.
authors: Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Jin
authors: J
authors: He
authors: John L
authors: JL
authors: Cameron
authors: Nita
authors: N
authors: Ahuja
authors: Martin A
authors: MA
authors: Makary
authors: Kenzo
authors: K
authors: Hirose
authors: Michael A
authors: MA
authors: Choti
authors: Richard D
authors: RD
authors: Schulick
authors: Ralph H
authors: RH
authors: Hruban
authors: Timothy M
authors: TM
authors: Pawlik
authors: Christopher L
authors: CL
authors: Wolfgang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment
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