title: Increased risk of second malignancy in pancreatic intraductal papillary mucinous tumors: Review of the literature.
abstract: OBJECTIVE
  To analyze the available evidence about the risk of extrapancreatic malignancies and pancreatic ductal adenocarcinoma associated to pancreatic intraductal papillary mucinous tumors (IPMNs).
  
  
  METHODS
  A systematic search of literature was undertaken using MEDLINE, EMBASE, Cochrane and Web-of-Science libraries. No limitations for year of publication were considered; preference was given to English papers. All references in selected articles were further screened for additional publications. Both clinical series and Literature reviews were selected. For all eligible studies, a standard data extraction form was filled in and the following data were extracted: study design, number of patients, prevalence of pancreatic cancer and extrapancreatic malignancies in IPMN patients and control groups, if available.
  
  
  RESULTS
  A total of 805 abstracts were selected and read; 25 articles were considered pertinent and 17 were chosen for the present systematic review. Eleven monocentric series, 1 multicentric series, 1 case-control study, 1 population-based study and 3 case report were included. A total of 2881 patients were globally analyzed as study group, and the incidence of pancreatic cancer and/or extrapancreatic malignancies ranged from 5% to 52%, with a mean of 28.71%. When a control group was analyzed (6 papers), the same incidence was as low as 9.4%.
  
  
  CONCLUSIONS
  The available Literature is unanimous in claiming IPMNs to be strongly associated with pancreatic and extrapancreatic malignancies. The consequences in IPMNs management are herein discussed.
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Baiocchi
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Molfino
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Frittoli
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Pigozzi
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Gheza
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Gaverini
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tarasconi
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Ricci
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bertagna
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Grazioli
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Guido A M
authors.initials: GA
authors.lastname: Tiberio
authors.affiliation: Gian Luca Baiocchi, Sarah Molfino, Federico Gheza, Giacomo Gaverini, Antonio Tarasconi, Guido AM Tiberio, Nazario Portolani, Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
authors.forename: Nazario
authors.initials: N
authors.lastname: Portolani
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000453:epidemiology* / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
keywords: 18FDG-PET; Computed tomography scan; Diagnosis; Follow-up; Intraductal papillary mucinous neoplasm; Pancreas; Tumors