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Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN).

Publication ,  Journal Article
Al Efishat, M; Attiyeh, MA; Eaton, AA; Gönen, M; Basturk, O; Klimstra, D; D'Angelica, MI; DeMatteo, RP; Kingham, TP; Balachandran, V; Allen, PJ ...
Published in: Ann Surg Oncol
June 2018

BACKGROUND: Although IPMN are thought to represent a whole-gland disease, segmental resection remains the most frequently performed treatment. We sought to determine the rates, patterns, and predictors of IPMN progression in the pancreatic remnant following segmental resection of noninvasive or microinvasive IPMN. METHODS: A prospectively maintained database was queried to identify all patients who underwent resection of noninvasive or microinvasive IPMN (≤ 10 mm of invasive component) between 1989 and 2015. Progression (recurrence) was defined as either the development of cancer, a new IPMN cystic lesion > 1 cm or ≥ 50% increase in the diameter of residual IPMN lesions in the remnant. Univariate and multivariate cox regression models were created to determine predictors of progression. RESULTS: A total of 319 patients underwent resection for noninvasive and microinvasive IPMN. The median age was 68, 53% had branch-duct (BD) IPMN, and 6% had microinvasive disease. After a median follow-up of 42 months, 71 patients (22%) experienced IPMN progression. Within this group of 71 patients, 11 (16% of recurrence) developed invasive cancer in the pancreatic remnant after a median of 28 months. Twelve patients (17%) experienced progression > 5 years following initial resection. On multivariate analysis, a distal location of the initial lesion was associated with an increased risk of progression (multivariate hazards ratio = 2.43, confidence interval 1.47-4.0, p < 0.001). CONCLUSIONS: In this study, 22% of patients had disease progression following resection of noninvasive or microinvasive IPMN; 16% of these progressions represented invasive disease. These patients represent a high-risk group and should undergo long-term radiographic surveillance.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

June 2018

Volume

25

Issue

6

Start / End Page

1752 / 1759

Location

United States

Related Subject Headings

  • Tumor Burden
  • Tomography, X-Ray Computed
  • Survival Rate
  • Retrospective Studies
  • Progression-Free Survival
  • Pancreatic Intraductal Neoplasms
  • Pancreatectomy
  • Pancreas
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
 

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Al Efishat, M., Attiyeh, M. A., Eaton, A. A., Gönen, M., Basturk, O., Klimstra, D., … Allen, P. J. (2018). Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN). Ann Surg Oncol, 25(6), 1752–1759. https://doi.org/10.1245/s10434-018-6445-2
Al Efishat, Mohammad, Marc A. Attiyeh, Anne A. Eaton, Mithat Gönen, Olca Basturk, David Klimstra, Michael I. D’Angelica, et al. “Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN).Ann Surg Oncol 25, no. 6 (June 2018): 1752–59. https://doi.org/10.1245/s10434-018-6445-2.
Al Efishat M, Attiyeh MA, Eaton AA, Gönen M, Basturk O, Klimstra D, et al. Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN). Ann Surg Oncol. 2018 Jun;25(6):1752–9.
Al Efishat, Mohammad, et al. “Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN).Ann Surg Oncol, vol. 25, no. 6, June 2018, pp. 1752–59. Pubmed, doi:10.1245/s10434-018-6445-2.
Al Efishat M, Attiyeh MA, Eaton AA, Gönen M, Basturk O, Klimstra D, D’Angelica MI, DeMatteo RP, Kingham TP, Balachandran V, Jarnagin WR, Allen PJ. Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN). Ann Surg Oncol. 2018 Jun;25(6):1752–1759.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

June 2018

Volume

25

Issue

6

Start / End Page

1752 / 1759

Location

United States

Related Subject Headings

  • Tumor Burden
  • Tomography, X-Ray Computed
  • Survival Rate
  • Retrospective Studies
  • Progression-Free Survival
  • Pancreatic Intraductal Neoplasms
  • Pancreatectomy
  • Pancreas
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local