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Multicenter Study
. 2007 Jul;133(1):72-9; quiz 309-10.
doi: 10.1053/j.gastro.2007.05.010. Epub 2007 May 10.

"V体育安卓版" Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection

Affiliations
Multicenter Study

Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection

J Ruben Rodriguez et al. Gastroenterology. 2007 Jul.

Abstract

Background & aims: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas arising in branch ducts are thought to be less aggressive than their main-duct counterparts, and guidelines for their conservative management were recently proposed VSports手机版. This study describes the combined experience of 2 tertiary centers with branch-duct IPMNs aiming to validate these recommendations. .

Methods: A review of 145 patients with resected, pathologically confirmed, branch-duct IPMNs between 1990 and 2005 was conducted. V体育安卓版.

Results: Sixty-six patients (45. 5%) had adenoma, 47 (32%) borderline tumors, 16 (11%) carcinoma in situ, and 16 (11%) invasive carcinoma. Median age was similar between benign and malignant subgroups (66 vs 67. 5 years, respectively). Jaundice was more frequent in patients with cancer (12. 5% vs 1. 8%, respectively, P = . 022) and abdominal pain in patients with benign tumors (45% vs 25%, respectively, P = . 025). Forty percent of tumors were discovered incidentally. Findings associated with malignancy were the presence of a thick wall (P < V体育ios版. 001), nodules (P < . 001), and tumor diameter >or=30 mm (P < . 001). All neoplasms with cancer were larger than 30 mm in size or had nodules or caused symptoms. After a mean follow-up of 45 months, the 5-year disease-specific survival for branch-duct IPMNs with noninvasive neoplasms was 100% and, for invasive cancer, was 63%. .

Conclusions: This large cohort of resected branch-duct IPMNs shows that cancer is present in 22% of cases and validates the recent guidelines that indicate absence of malignancy in tumors <30 mm, without symptoms or mural nodules. VSports最新版本.

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Figures

Figure 1
Figure 1
(A) Distribution of overall number of pancreatic resections by year for branch-duct IPMNs (n =145). (B) Symptomatic vs incidentally discovered pancreatic resections for branch-duct IPMNs (2002–2005).
Figure 2
Figure 2
Scatter plot of radiologic tumor size as a function of histologic subtype and presence or absence of symptoms and nodules.
Figure 3
Figure 3
(A) Overall 5- and 10-year survival for the entire series were 95% and 70%, respectively. (B) The 5-year disease-specific survival was 100% for patients affected by adenoma, borderline, or carcinoma in situ and 63% for the 16 patients with invasive carcinoma.

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References

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