Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: clinicopathological features and long-term outcomes following a pancreatectomy

  1. Antoñanzas, Javier 1
  2. A. Cienfuegos, Javier 123
  3. Hurtado-Pardo, Luis 1
  4. Panadero, Pablo 1
  5. Benito, Alberto 1
  6. Pardo, Fernando 1
  7. Rotellar, Fernando 1
  8. Martí-Cruchaga, Pablo 1
  9. Zozaya, Gabriel 1
  10. Valentí, Víctor 1
  11. Hernández Lizoain, José Luis 1
  1. 1 Clínica Universitaria de Navarra
    info

    Clínica Universitaria de Navarra

    Pamplona, España

    ROR https://ror.org/03phm3r45

  2. 2 Instituto de Investigación Sanitaria de Navarra
    info

    Instituto de Investigación Sanitaria de Navarra

    Pamplona, España

  3. 3 Instituto de Salud Carlos III
    info

    Instituto de Salud Carlos III

    Madrid, España

    ROR https://ror.org/00ca2c886

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Revista:
Revista Española de Enfermedades Digestivas

ISSN: 1130-0108

Año de publicación: 2018

Volumen: 110

Número: 12

Páginas: 768-774

Tipo: Artículo

DOI: 10.17235/REED.2018.5646/2018 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista Española de Enfermedades Digestivas

Resumen

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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