Objective: To determine the occurrence of new disease in the pancreatic remnant after resection for intraductal papillary mucinous neoplasms.
Design: A longitudinal level II cohort study.
Setting: Virginia Mason Medical Center, Seattle, Washington.
Patients: The primary cohort was a "resection cohort" of 203 patients who underwent partial pancreatic resection for an intraductal papillary mucinous neoplasm.
Main Outcome Measures: The occurrence rate of lesions in the pancreatic remnant after resection for an intraductal papillary mucinous neoplasm, determined by use of an annual computed tomographic scan of the pancreas.
Results: New lesions were observed in the remnant of 17 of the 203 patients (8%) after a median follow-up of 40 months and a median interval of 38 months from the initial resection. Only 1 of these 17 patients with new lesions had a surgical margin that was positive for an adenoma at the time of resection. Comparing the 17 patients with new lesions with the 186 patients without new lesions, we found no difference in age, sex, procedure type, location in ductal system, original histology, or original margin status. In the new lesion group, no treatment was used for 12 patients who had side-branch disease detected by imaging (6% of all patients). Surgical treatment was used for 5 patients (2% of all patients): 2 with adenomas, 1 with a carcinoma in situ, and 2 with an invasive ductal carcinoma (1 with liver metastases).
Conclusions: We found that, following a partial pancreatic resection for an intraductal papillary mucinous neoplasm and a 40-month follow-up with an annual computed tomographic scan of the pancreas, 17 of 203 patients (8%) developed a new intraductal papillary mucinous neoplastic lesion in the pancreatic remnant. As follow-up time increases, we suspect that new lesions will constantly appear regardless of whether the surgical margin was negative at initial resection.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/archsurg.2011.2276 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
SURVEILLANCE OF SUB-CENTIMETER SIDE-BRANCH IPMNS: RISK OF INVASIVE DISEASE AND FOLLOW-UP RECOMMENDATIONS.
J Gastrointest Surg
January 2025
Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH.
Article Synopsis
- The study assesses the risk associated with sub-centimeter Side-Branch Intraductal Papillary Mucinous Neoplasms (SB-IPMN) to inform a surveillance strategy.
- Sub-centimeter SB-IPMNs show a lower rate of clinically relevant progression compared to larger cysts, although they can still develop high-risk pathologies over time.
- The findings suggest that size growth alone is not a reliable indicator of malignant potential, emphasizing the need for careful monitoring regardless of cyst size.
Distinct prognostic impacts of age-adjusted Charlson comorbidity index and geriatric nutritional risk index in patients with intraductal papillary mucinous neoplasm.
Medicine (Baltimore)
January 2025
Department of the Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
The optimal surgical indication for intraductal papillary mucinous neoplasms (IPMN) remains highly contentious. We aimed to determine the preoperative predictive factors of malignancy and independent prognostic factors in patients with IPMN who underwent curative-intent resection. In this study, 104 patients with a pathological diagnosis of IPMN who underwent curative-intent resection were included.
View Article and Find Full Text PDFAdjuvant Chemotherapy on Resected Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Cancer: Addressing Statistical and Methodological Concerns in Survival Analysis.
J Clin Oncol
January 2025
Guang Xiong, MMed, Department of Geriatric Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Reply to: Adjuvant Chemotherapy on Resected Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Cancer: Addressing Statistical and Methodological Concerns in Survival Analysis.
J Clin Oncol
January 2025
Joseph R. Habib, MD, Ammar A. Javed, MD, and Christopher L. Wolfgang, MD, PhD, New York University Grossman School of Medicine, New York, NY.
Applications of Artificial Intelligence in Gastrointestinal Endoscopic Ultrasound: Current Developments, Limitations and Future Directions.
Cancers (Basel)
December 2024
Digestive Diseases and Surgery Institute, Cleveland Clinic, London SW1X 7HY, UK.
Endoscopic ultrasound (EUS) effectively diagnoses malignant and pre-malignant gastrointestinal lesions. In the past few years, artificial intelligence (AI) has shown promising results in enhancing EUS sensitivity and accuracy, particularly for subepithelial lesions (SELs) like gastrointestinal stromal tumors (GISTs). Furthermore, AI models have shown high accuracy in predicting malignancy in gastric GISTs and distinguishing between benign and malignant intraductal papillary mucinous neoplasms (IPMNs).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!