Skip to main content
Journal cover image

Incidentally discovered pancreatic intraepithelial neoplasia: what is its clinical significance?

Publication ,  Journal Article
Konstantinidis, IT; Vinuela, EF; Tang, LH; Klimstra, DS; D'Angelica, MI; Dematteo, RP; Kingham, TP; Fong, Y; Jarnagin, WR; Allen, PJ
Published in: Ann Surg Oncol
October 2013

PURPOSE: Pancreatic intraepithelial neoplasia (PanIN) is a presumed precursor of pancreatic ductal adenocarcinoma (PDAC). We assessed the relationship between incidental PanIN after resection of non-adenocarcinoma lesions and the development of metachronous PDAC in the remnant. METHODS: We retrospectively reviewed the clinicopathologic data of patients who underwent pancreatectomy for non-PDAC from January 2000 to January 2010. Intraductal papillary mucinous lesions were excluded. All available postoperative imaging and clinical follow-up data were reviewed; the risk of developing PDAC was assessed in patients with a minimum follow-up time of 6 months and with imaging studies available for review. RESULTS: A total of 584 patients were analyzed. Median age was 59 years (range 10-85 years), and 338 (58 %) were female. The most common lesions for which resection was performed were serous cystic neoplasms (17 %), pancreatic neuroendocrine tumors (38 %), metastatic tumors (9 %), and mucinous cystic neoplasms (7 %). PanIN was identified in 153 (26 %) patients. The majority of these patients had PanIN-1 or -2 (50 and 41 %, respectively), whereas 13 (8 %) had PanIN-3. Of the 506 (87 %) patients with adequate follow-up (median 3.7 years, range 0.5-12.6 years), 1 patient (0.2 %) with PanIN identified at the time of initial resection developed cancer in the remnant. This occurred 4.4 years after a distal pancreatectomy in the setting of PanIN-1B. No patient with PanIN-3 developed cancer during follow-up. CONCLUSIONS: PanIN was identified in 26 % of patients who underwent resection for histopathology other than PDAC. The presence of PanIN of any grade did not result in an appreciable cancer risk in the pancreatic remnant after short-term follow-up.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

October 2013

Volume

20

Issue

11

Start / End Page

3643 / 3647

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Prognosis
  • Pancreatic Neoplasms
  • Pancreatectomy
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoplasm Staging
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Konstantinidis, I. T., Vinuela, E. F., Tang, L. H., Klimstra, D. S., D’Angelica, M. I., Dematteo, R. P., … Allen, P. J. (2013). Incidentally discovered pancreatic intraepithelial neoplasia: what is its clinical significance? Ann Surg Oncol, 20(11), 3643–3647. https://doi.org/10.1245/s10434-013-3042-2
Konstantinidis, Ioannis T., Eduardo F. Vinuela, Laura H. Tang, David S. Klimstra, Michael I. D’Angelica, Ronald P. Dematteo, T Peter Kingham, Yuman Fong, William R. Jarnagin, and Peter J. Allen. “Incidentally discovered pancreatic intraepithelial neoplasia: what is its clinical significance?Ann Surg Oncol 20, no. 11 (October 2013): 3643–47. https://doi.org/10.1245/s10434-013-3042-2.
Konstantinidis IT, Vinuela EF, Tang LH, Klimstra DS, D’Angelica MI, Dematteo RP, et al. Incidentally discovered pancreatic intraepithelial neoplasia: what is its clinical significance? Ann Surg Oncol. 2013 Oct;20(11):3643–7.
Konstantinidis, Ioannis T., et al. “Incidentally discovered pancreatic intraepithelial neoplasia: what is its clinical significance?Ann Surg Oncol, vol. 20, no. 11, Oct. 2013, pp. 3643–47. Pubmed, doi:10.1245/s10434-013-3042-2.
Konstantinidis IT, Vinuela EF, Tang LH, Klimstra DS, D’Angelica MI, Dematteo RP, Kingham TP, Fong Y, Jarnagin WR, Allen PJ. Incidentally discovered pancreatic intraepithelial neoplasia: what is its clinical significance? Ann Surg Oncol. 2013 Oct;20(11):3643–3647.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

October 2013

Volume

20

Issue

11

Start / End Page

3643 / 3647

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Prognosis
  • Pancreatic Neoplasms
  • Pancreatectomy
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoplasm Staging
  • Middle Aged
  • Male