title: Association between pancreatic intraductal papillary mucinous neoplasms and extrapancreatic malignancies.
abstract: OBJECTIVE
  The association between pancreatic intraductal papillary mucinous neoplasms (IPMNs) and extrapancreatic neoplasms (EPNs) is controversial. We performed a multicenter observational study to assess the incidence of EPNs after an IPMN diagnosis.
  
  
  METHODS
  1340 patients with IPMNs were evaluated from 2000 through 2013 at 4 academic institutions in Europe for development of EPN. To estimate the actual incidence of EPN, we excluded patients with an EPN previous or synchronous to the IPMN, and patients who had been followed for less than 12 months, resulting in a study population of 816 patients. The incidence of EPN was compared with sex-specific, age-adjusted European cancer statistics; the standardized incidence ratio (SIR), and the 5- and 10-year cumulative incidence rates were calculated.
  
  
  RESULTS
  A total of 290/1340 patients had a history of EPN (prevalence of 21.6%). In this subgroup of patients, the IPMN was discovered incidentally in 241. Among the 816 patients included in the incidence analysis, 50 developed an EPN after a median time of 46 months from study enrollment. The incidence of any EPN was not greater in patients with than without IPMN with a SIR of 1.48 (95% confidence interval, 0.94-2.22) in males and of 1.39 (95% CI 0.90-2.05) in females. The 5- and 10-year cumulative incidence rates for development of EPN in patients with IPMN were 7.9% and 16.6% in men, and 3.4% and 23.1% in women.
  
  
  CONCLUSIONS
  Patients with IPMN do not have a significantly higher incidence of EPNs than the general European population. It might not be necessary to screen patients with IPMN for EPN.
authors.affiliation: Unit of Surgery B, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. Electronic address: giovanni.marchegiani@ospedaleuniverona.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Marchegiani
authors.affiliation: Unit of Surgery B, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Malleo
authors.affiliation: Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Jan G
authors.initials: JG
authors.lastname: D'Haese
authors.affiliation: Department of Gastroenterology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Wenzel
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Ege University, Izmir, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Keskin
authors.affiliation: Unit of General Surgery 2, Department of Surgery, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pugliese
authors.affiliation: Unit of Surgery B, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
authors.forename: Alex
authors.initials: A
authors.lastname: Borin
authors.affiliation: Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Valentina
authors.initials: V
authors.lastname: Benning
authors.affiliation: Division of Surgery, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Nilsson
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Ege University, Izmir, Turkey.
authors.forename: Nevin
authors.initials: N
authors.lastname: Oruc
authors.affiliation: Division of Surgery, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Ralf
authors.initials: R
authors.lastname: Segersvard
authors.affiliation: Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.affiliation: Department of Gastroenterology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Schmid
authors.affiliation: Division of Gastroenterology, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Matthias
authors.initials: M
authors.lastname: Löhr
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.affiliation: Unit of Surgery B, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.affiliation: Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Güralp O
authors.initials: GO
authors.lastname: Ceyhan
authors.affiliation: Unit of Surgery B, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.affiliation: Division of Surgery, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Marco
authors.initials: M
authors.lastname: Del Chiaro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications*; D002291:Carcinoma, Papillary / Q000150:complications*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000150:complications*; D015995:Prevalence; D055815:Young Adult
keywords: Cancer; Cystic Lesion of the Pancreas; Extrapancreatic Tumors; Follow Up