Year 2018 / Volume 110 / Number 12
Original
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: clinicopathological features and long-term outcomes following a pancreatectomy

768-774

DOI: 10.17235/reed.2018.5646/2018

Javier Antoñanzas, Javier A. Cienfuegos, Luis Hurtado-Pardo, Pablo Panadero, Alberto Benito, Fernando Pardo, Fernando Rotellar, Pablo Martí-Cruchaga, Gabriel Zozaya, Víctor Valentí, José Luis Hernández Lizoain,

Abstract
Objective: the objective of this study was to analyze the anatomical and clinical features and long-term oncologic outcomes of 25 patients that underwent surgery due to intraductal papillary mucinous neoplasm of the pancreas. Material and methods: patients undergoing surgery for intraductal papillary mucinous neoplasm of the pancreas were identified from a prospective database of pancreatic resections. Demographic data, symptoms, type of surgery and type of lesion (branch type, main duct or mixed) were recorded. The lesions were classified into invasive (high grade dysplasia and carcinoma) and noninvasive (low- or intermediate-grade dysplasia). Postoperative complications were analyzed as well as the pattern of recurrence and disease-free survival at five and ten years. Results: the most common symptoms in the 25 patients (14 males and eleven females) were abdominal pain and weight loss. Eight (32%) cases were diagnosed incidentally. Twelve (48%) of the lesions were of the branch type, three affected the main duct and ten (40%) were mixed. Twelve cephalic duodenopancreatectomies and seven total pancreatectomies were performed; three were central; two, distal; and one, enucleation. Seven cases (32%) had an invasive phenotype. Three patients had locoregional and distant recurrence at six, 16 and 46 months after surgery with a median follow-up of 7.7 years. Disease-free survival at five and ten years for the noninvasive type was 94% and 57% for invasive phenotypes (p < 0.05). Conclusions: intraductal papillary mucinous neoplasm is a heterogeneous entity with well differentiated phenotypes, which requires a tailored strategy and treatment, as established in the current consensus guidelines due to its malignant potential.
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Antoñanzas J, A. Cienfuegos J, Hurtado-Pardo L, Panadero P, Benito A, Pardo F, et all. Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: clinicopathological features and long-term outcomes following a pancreatectomy. 5646/2018


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Publication history

Received: 11/04/2018

Accepted: 11/06/2018

Online First: 28/08/2018

Published: 03/12/2018

Article revision time: 56 days

Article Online First time: 139 days

Article editing time: 236 days


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