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10.1245/s10434-007-9546-x
Annals of Surgical Oncology 14:3174-3180 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Surgical Outcome of Intraductal Papillary Mucinous Neoplasms of the Pancreas

Toshio Nakagohri, PhD, Taira Kinoshita, PhD, Masaru Konishi, MD, Shinichiro Takahashi, PhD and Naoto Gotohda, PhD

Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan

Correspondence: Address correspondence and reprint requests to: Toshio Nakagohri, PhD; E-mail: tnakagor{at}east.ncc.go.jp

Objective: An increasing number of intraductal papillary mucinous neoplasms of the pancreas have been reported in recent years. However, the clinicopathologic features and surgical outcome of this neoplasm are not fully understood because of the limited number of cases. The objective of this study is to clarify the clinicopathologic features of intraductal papillary mucinous neoplasm of the pancreas and evaluate prognostic factors influencing survival.

Methods: Eighty-two patients with intraductal papillary mucinous neoplasm undergoing surgical resection at the National Cancer Center Hospital East between April 1994 and October 2006 were retrospectively analyzed.

Results: There were 31 patients with adenoma and 51 patients with carcinoma. Carcinomas were subdivided into noninvasive carcinoma (n = 14), minimally invasive carcinoma (n = 6), and invasive carcinoma (n = 31). The postoperative mortality rate was 0%. The 5-year survival rate for patients with intraductal papillary mucinous adenoma, noninvasive carcinoma, minimally invasive carcinoma, and invasive carcinoma was 80%, 78%, 83%, and 24%, respectively. Regardless of the margin status, no patient with adenoma developed recurrent disease. There were significant differences in survival between noninvasive carcinoma and invasive carcinoma (P = .016) and between minimally invasive carcinoma and invasive carcinoma (P = .030). Multivariate analysis confirmed that lymph node metastasis (P = .004) and age (P = .015) were significant prognostic factors after surgical resection of these neoplasms.

Conclusions: Patients with intraductal papillary mucinous adenoma, noninvasive carcinoma, and minimally invasive carcinoma showed favorable survival. In contrast, invasive intraductal papillary mucinous carcinoma was associated with poor survival regardless of the margin status. Nodal involvement was the strongest predictor of poor survival.

Key Words: Intraductal papillary mucinous neoplasm • Pancreatic resection • Nodal involvement • Invasive carcinoma • Noninvasive carcinoma






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