Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas

被引:371
作者
Chari, ST
Yadav, D
Smyrk, TC
DiMagno, EP
Miller, LJ
Raimondo, M
Clain, JE
Norton, IA
Pearson, RK
Petersen, BT
Wiersema, MJ
Farnell, MB
Sarr, MG
机构
[1] Mayo Clin & Mayo Fdn, Div Gastroenterol & Hepatol, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Dept Pathol, Rochester, MN 55905 USA
[3] Mayo Clin, Div Gastroenterol, Jacksonville, FL 32224 USA
[4] Mayo Clin, Div Gastroenterol & Gen Surg, Rochester, MN USA
关键词
D O I
10.1053/gast.2002.36552
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: The aim of this study was to determine recurrence and long-term survival after resection of pancreatic intraductal papillary mucinous neoplasm and to correlate recurrence and survival with histology, extent of resection, and duration of follow-up. Methods: A single pathologist, without knowledge of previous interpretations of histology or clinical data, retrospectively reviewed and classified 113 resected intraductal papillary mucinous neoplasms as invasive carcinoma (n = 40) or as noninvasive neoplasms (adenoma, borderline, or carcinoma in situ; n = 73). Data on recurrence (locoregional or metastatic), follow-up, and cause of death were obtained from patient records and/or by contacting patients and their physicians. Results: In invasive intraductal papillary mucinous neoplasm, recurrence was similar after partial pancreatectomy (18/27; 67%) and total pancreatectomy (8/13; 62%) and occurred within 3 years of resection in 91%. Among noninvasive neoplasms, 5 of 60 (8%) recurred after partial pancreatectomy (median follow-up, 37 months); none recurred after total pancreatectomy (n = 13; median follow-up, 32 months). Recurrence after resection in noninvasive neoplasms was diagnosed after a median of 40 months (range, 23-75 months); recurrence was noninvasive in 3 and invasive cancer in 2. Five-year survival was better for noninvasive compared with invasive intraductal papillary mucinous neoplasm (84.5% vs. 36%; P < 0.001). Conclusions: Invasive intraductal papillary mucinous neoplasm recurs frequently even after a complete "curative" resection and portends poor survival. In contrast, noninvasive intraductal papillary mucinous neoplasm recurs infrequently after resection, and survival is excellent regardless of the degree of epithelial dysplasia in the tumor.
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页码:1500 / 1507
页数:8
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