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

Suresh T Chari, Dhiraj Yadav, Thomas Christopher Smyrk, Eugene P. DiMagno, Laurence J Miller, Massimo Raimondo, Jonathan E. Clain, Ian A. Norton, Randall K. Pearson, Bret Thomas Petersen, Maurits J. Wiersema, Michael B. Farnell, Michael G. Sarr

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1500-1507
Number of pages8
JournalGastroenterology
Volume123
Issue number5
StatePublished - Nov 1 2002

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Pancreatic Neoplasms
Recurrence
Pancreatectomy
Neoplasms
Survival
Histology
Carcinoma in Situ
Adenoma
Cause of Death
Carcinoma
Physicians

ASJC Scopus subject areas

  • Gastroenterology

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Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. / Chari, Suresh T; Yadav, Dhiraj; Smyrk, Thomas Christopher; DiMagno, Eugene P.; Miller, Laurence J; Raimondo, Massimo; Clain, Jonathan E.; Norton, Ian A.; Pearson, Randall K.; Petersen, Bret Thomas; Wiersema, Maurits J.; Farnell, Michael B.; Sarr, Michael G.

In: Gastroenterology, Vol. 123, No. 5, 01.11.2002, p. 1500-1507.

Research output: Contribution to journalArticle

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 2002, 'Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas', Gastroenterology, vol. 123, no. 5, pp. 1500-1507.
Chari, Suresh T ; Yadav, Dhiraj ; Smyrk, Thomas Christopher ; DiMagno, Eugene P. ; Miller, Laurence J ; Raimondo, Massimo ; Clain, Jonathan E. ; Norton, Ian A. ; Pearson, Randall K. ; Petersen, Bret Thomas ; Wiersema, Maurits J. ; Farnell, Michael B. ; Sarr, Michael G. / Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. In: Gastroenterology. 2002 ; Vol. 123, No. 5. pp. 1500-1507.
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abstract = "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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T1 - Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas

AU - Chari, Suresh T

AU - Yadav, Dhiraj

AU - Smyrk, Thomas Christopher

AU - DiMagno, Eugene P.

AU - Miller, Laurence J

AU - Raimondo, Massimo

AU - Clain, Jonathan E.

AU - Norton, Ian A.

AU - Pearson, Randall K.

AU - Petersen, Bret Thomas

AU - Wiersema, Maurits J.

AU - Farnell, Michael B.

AU - Sarr, Michael G.

PY - 2002/11/1

Y1 - 2002/11/1

N2 - 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.

AB - 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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M3 - Article

VL - 123

SP - 1500

EP - 1507

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 5

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