Format

Send to

Choose Destination
See comment in PubMed Commons below
Ann Surg. 2007 Oct;246(4):644-51; discussion 651-4.

Intraductal papillary mucinous neoplasms: predictors of malignant and invasive pathology.

Author information

  • 1Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA. maxschmi@iupui.edu

Abstract

OBJECTIVE:

Determine whether size and other preoperative parameters predict malignant or invasive intraductal papillary mucinous neoplasia (IPMN).

SUMMARY BACKGROUND DATA:

From 1991 to 2006, 150 patients underwent 156 operations for IPMN.

METHODS:

Prospectively collected, retrospective review of a single academic institution's experience. All preoperative parameters including a detailed radiologic-based classification of IPMN type, location, distribution, size, number, cytology, and mural nodularity were correlated with IPMN pathology.

RESULTS:

Malignant IPMN was present in 32% of cases, whereas 19% of cases were invasive. IPMN type and main pancreatic duct diameter were significant predictors of malignant IPMN (P<0.001). Side-branch lesion number was negatively associated with invasive IPMN (P=0.03). Side-branch size, location, and distribution did not predict IPMN pathology. The presence of mural nodules was associated with malignant and invasive IPMN (P<0.001; P<0.02). Atypical cytopathology was significantly associated with malignant and invasive IPMN (P<0.001; P<0.001). Multivariate analysis demonstrated mural nodularity and atypical cytopathology were predictive of malignancy and/or invasion in branch-type IPMN.

CONCLUSIONS:

To lower the rate of invasive pathology, surgery should be recommended for fit patients with main-duct IPMN and for branch-duct IPMN with mural nodularity or positive cytology irrespective of location, distribution, or size.

PMID:
17893501
DOI:
10.1097/SLA.0b013e318155a9e5
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Support Center