title: Positive surgical margins in surgically treated unifocal and multifocal IPMN.
abstract: BACKGROUND
  Although treatment methods for the positive margins of surgically treated intraductal papillary mucinous neoplasms (IPMNs) are established, the significance of the positive surgical margins remains unclear. We aimed to clarify the risk factors of the positive margins and their impact on the recurrence of cystic lesions.
  
  
  METHODS
  Fifty-five surgically treated IPMN cases occurring at the Ogaki Municipal Hospital from 2004 to 2013 were analyzed retrospectively.
  
  
  RESULTS
  Out of the 55 IPMN patients who underwent pancreatectomy, positive surgical margins were found in 16 cases. Most of the positive surgical margin cases were found to be a multifocal IPMN; specifically, 9 out of 19 were a multifocal IPMN case, and 7 out of 36 were a unifocal IPMN case (47.4% and 19.4%, respectively, p = 0.030). Recurrences of cystic lesions in the remnant pancreases were found in 7 cases; 4 out of 16 cases were in the positive margin group, and 3 out of 39 were in the negative margin group (25.0% and 7.7%, respectively, p = 0.080). While a positive margin was a significant risk factor in unifocal IPMN (p = 0.031), it was not in multifocal IPMN (p = 0.90).
  
  
  CONCLUSIONS
  Positive surgical margins are frequently found in multifocal IPMNs and might include false positive margins.
authors.affiliation: Division of Digestive Surgery, Ogaki Municipal Hospital, Gifu, Japan. Electronic address: jumpei@med.nagoya-u.ac.jp.
authors.forename: Junpei
authors.initials: J
authors.lastname: Yamaguchi
authors.affiliation: Division of Digestive Surgery, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaneoka
authors.affiliation: Division of Digestive Surgery, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Maeda
authors.affiliation: Division of Digestive Surgery, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takayama
authors.affiliation: Division of Digestive Surgery, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onoe
authors.affiliation: Division of Digestive Surgery, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Isogai
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
keywords: Multifocal IPMN; Recurrence; Surgical margin