AI Article Synopsis
- The study investigates treatment strategies for patients with multifocal intraductal papillary mucinous neoplasms (MF-IPMNs) and how their surgical outcomes compare to those with unifocal IPMNs.
- A total of 194 patients were analyzed, finding no significant differences in 5-year disease-specific survival rates between those with MF-IPMNs and unifocal IPMNs.
- The research concluded that each cyst in MF-IPMNs should be individually assessed for cancer-related characteristics, highlighting lymph node metastasis as a key survival predictor.
Article Abstract
Background: The decision to perform surgery is complicated by the presence of multifocal (MF) intraductal papillary mucinous neoplasms (IPMNs), which are characterized by two or more cysts located in different areas of the pancreas.
Objectives: We aimed to establish a suitable treatment strategy and surgical indications in patients with MF-IPMNs.
Methods: This single-center retrospective study included patients with IPMNs who underwent pancreatic resection from 2006 to 2020. Patients with distant metastasis and patients with IPMNs of the main pancreatic duct were excluded from the analysis.
Results: After excluding 22 patients, 194 patients were included. One hundred thirteen patients (58.2%) had unifocal IPMNs, while 81 patients (41.8%) had MF-IPMNs. There were no significant differences in the 5-year disease-specific survival (DSS) rate (92.3% vs. 92.4%, p = 0.976) and the 5-year disease-free survival rate (88.6% vs. 86.5%, p = 0.461). The multivariate analysis identified high-risk stigmata, invasive carcinoma, and lymph node metastasis as independent predictors of DSS. The presence of cystic lesions in the pancreatic remnant was not a predictor of survival. Even in the MF-IPMN group, there were no significant differences in DSS when stratified by procedure (total pancreatectomy vs. segmental pancreatectomy, p = 0.268) or presence of cystic lesions in the pancreatic remnant (p = 0.476). The multivariate analysis identified lymph node metastasis as an independent predictor of DSS in the MF-IPMN group.
Conclusions: In patients with MF-IPMNs, each cyst should be evaluated individually for the presence of features associated with malignancy.
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| http://dx.doi.org/10.1016/j.pan.2022.07.004 | DOI Listing |
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