Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas

• Published in: The American journal of surgery Vol. 204; no. 1; pp. 44 - 48
• Main Authors: Ohtsuka, Takao, M.D, Kono, Hiroshi, M.D, Tanabe, Reiko, M.D, Nagayoshi, Yosuke, M.D, Mori, Yasuhisa, M.D, Sadakari, Yoshihiko, M.D, Takahata, Shunichi, M.D, Oda, Yasunori, M.D, Aishima, Shinichi, M.D, Igarashi, Hisato, M.D, Ito, Tetsuhide, M.D, Ishigami, Kousei, M.D, Nakamura, Masafumi, M.D, Mizumoto, Kazuhiro, M.D, Tanaka, Masao, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2012; Elsevier; Elsevier Limited
• Subjects: Adenocarcinoma, Mucinous - surgery; Adult; Aged; Biological and medical sciences; Carcinoma, Pancreatic Ductal - epidemiology; Carcinoma, Pancreatic Ductal - surgery; Carcinoma, Papillary - surgery; Disease; Endoscopy; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; IPMN; Japan - epidemiology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Magnetic resonance imaging; Male; Medical Records; Medical sciences; Metastasis; Middle Aged; Multifocal; Neoplasms, Second Primary - diagnosis; Neoplasms, Second Primary - epidemiology; Neoplasms, Second Primary - etiology; Pancreatectomy; Pancreatic cancer; Pancreatic ductal adenocarcinoma; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - surgery; Population Surveillance; Retrospective Studies; Surgery; Surveillance; Time Factors; Tumors; Japan; Multifocal; Pancreatic ductal adenocarcinoma; IPMN; Ductal carcinoma; Reference; Surgical resection; Pancreas ductal adenocarcinoma; Malignant tumor; Medicine; Persistence; Treatment; Follow up study; Surgery; Pancreas cancer; Development; Digestive diseases; Lesion; Pancreas; Cancer; Pancreatic disease
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2011.04.007

Abstract Background Frequency and characteristics of metachronous occurrence of multifocal intraductal papillary mucinous neoplasms (IPMNs) or distinct pancreatic ductal adenocarcinomas (PDACs) in the remnant pancreas during follow-up evaluation after pancreatectomy for IPMNs have not been well known. The aim of this study was to investigate the outcomes after resection of IPMNs, especially focusing on the metachronous occurrence of multifocal IPMNs and distinct PDACs. Methods Medical records of 172 patients who underwent resection of IPMNs were reviewed retrospectively, and the data regarding the occurrence of metachronous IPMNs or PDACs in the remnant pancreas during a mean postoperative follow-up period of 64 months were collected. Results The incidence including synchronous and metachronous multifocal occurrence of IPMNs was 20% (34 of 172), and that of distinct PDACs was 9.9% (17 of 172). Ten metachronous IPMNs developed in the remnant pancreas after a mean time of 23 postoperative months (range, 12–84 mo), and 2 with main duct IPMNs (both were carcinoma in situ) required remnant pancreatectomy. Six distinct PDACs developed in the remnant pancreas after a mean time of 84 postoperative months (range, 12–150 mo). Four of them were found to have a tumor with a size of less than 2 cm, whereas the remaining 2 PDACs were found to be unresectable more than 10 years after resection of IPMNs. Conclusions Intense long-term follow-up evaluation is necessary for the early detection of metachronous occurrence of distinct PDACs as well as malignant IPMNs after resection of IPMNs.