title: Smoking and IPMN malignant progression.
abstract: BACKGROUND
  Patients with intraductal papillary mucinous neoplasm (IPMN) are at risk for invasive pancreatic cancer. We aim to characterize the impact of smoking on IPMN malignant progression.
  
  
  METHODS
  Patients undergoing pancreatic resection for IPMN (1991-2015) were retrospectively reviewed using a prospectively collected database.
  
  
  RESULTS
  Of 422 patients identified, 324 had complete data for analysis; 55% were smokers. Smoking status did not impact IPMN malignant progression (smokers/non-smokers: 22%/18% invasive grade; p = 0.5). Smokers were younger than non-smokers at the time of IPMN diagnosis (63 versus 68 years; p = 0.001). This association also held in the invasive IPMN subgroup (65 versus 72 years, p = 0.01). Despite this observation, rate of symptoms at diagnosis, cancer stage, and median survival were the same between smokers and non-smokers.
  
  
  CONCLUSIONS
  Although smoking is not associated with IPMN malignant progression, invasive IPMN is diagnosed at a younger age in smokers. These data suggest tobacco exposure may accelerate IPMN malignant progression.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Carr
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Roch
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: K
authors.initials: K
authors.lastname: Shaffer
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Aboudi
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Schmidt
authors.affiliation: Department of Medicine, Division of Gastroenterology, Indiana University Hospital, Indianapolis, IN, USA.
authors.forename: J
authors.initials: J
authors.lastname: DeWitt
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: E P
authors.initials: EP
authors.lastname: Ceppa
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: House
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Zyromski
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: A
authors.initials: A
authors.lastname: Nakeeb
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: maxschmi@iupui.edu.
authors.forename: C M
authors.initials: CM
authors.lastname: Schmidt
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012907:Smoking
keywords: Age; Intraductal papillary mucinous neoplasm (IPMN); Smoking