Skip to main content
Journal cover image

Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms.

Publication ,  Journal Article
Frankel, TL; LaFemina, J; Bamboat, ZM; D'Angelica, MI; DeMatteo, RP; Fong, Y; Kingham, TP; Jarnagin, WR; Allen, PJ
Published in: HPB (Oxford)
October 2013

BACKGROUND: The significance of a positive margin in resected non-invasive pancreatic intraductal papillary mucinous neoplasms (IPMN) remains controversial. The aim of this study was to determine recurrence rates when dysplasia was present at the final surgical margin. METHODS: A prospectively maintained database identified 192 patients undergoing resection of non-invasive IPMN. Pathological, peri-operative and recurrence data were analysed. RESULTS: Ductal dysplasia was identified at the final surgical margin in 86 patients (45%) and defined as IPMN or Pancreatic Intraepithelial Neoplasia PanIN in 38 (20%) and 54 (28%) patients, respectively. At a median follow-up of 46 months, 40 (21%) patients recurred with 31 developing radiographical evidence of new cysts, 6 re-resected for IPMN and 3 diagnosed with pancreatic cancer within the remnant. Of those with margin dysplasia, 31% developed recurrent disease compared with 13% in those without dysplasia (P = 0.002). On multivariate analysis, margin dysplasia was associated with a three-fold increased risk of recurrence (P = 0.02). No relationship between dysplasia and development of pancreatic cancer was found. DISCUSSION: In this study, dysplasia at the margin after a pancreatectomy for non-invasive IPMN was associated with recurrence in the remnant gland, but not at the resection margin. While this finding may warrant closer follow-up, it does not identify a gland at higher risk for the subsequent development of invasive disease.

Duke Scholars

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

October 2013

Volume

15

Issue

10

Start / End Page

814 / 821

Location

England

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Pancreatic Neoplasms
  • Pancreatectomy
  • Neoplasms, Cystic, Mucinous, and Serous
  • Neoplasm, Residual
  • Neoplasm Recurrence, Local
  • Multivariate Analysis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Frankel, T. L., LaFemina, J., Bamboat, Z. M., D’Angelica, M. I., DeMatteo, R. P., Fong, Y., … Allen, P. J. (2013). Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms. HPB (Oxford), 15(10), 814–821. https://doi.org/10.1111/hpb.12137
Frankel, Timothy L., Jennifer LaFemina, Zubin M. Bamboat, Michael I. D’Angelica, Ronald P. DeMatteo, Yuman Fong, T Peter Kingham, William R. Jarnagin, and Peter J. Allen. “Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms.HPB (Oxford) 15, no. 10 (October 2013): 814–21. https://doi.org/10.1111/hpb.12137.
Frankel TL, LaFemina J, Bamboat ZM, D’Angelica MI, DeMatteo RP, Fong Y, et al. Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms. HPB (Oxford). 2013 Oct;15(10):814–21.
Frankel, Timothy L., et al. “Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms.HPB (Oxford), vol. 15, no. 10, Oct. 2013, pp. 814–21. Pubmed, doi:10.1111/hpb.12137.
Frankel TL, LaFemina J, Bamboat ZM, D’Angelica MI, DeMatteo RP, Fong Y, Kingham TP, Jarnagin WR, Allen PJ. Dysplasia at the surgical margin is associated with recurrence after resection of non-invasive intraductal papillary mucinous neoplasms. HPB (Oxford). 2013 Oct;15(10):814–821.
Journal cover image

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

October 2013

Volume

15

Issue

10

Start / End Page

814 / 821

Location

England

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Risk Factors
  • Pancreatic Neoplasms
  • Pancreatectomy
  • Neoplasms, Cystic, Mucinous, and Serous
  • Neoplasm, Residual
  • Neoplasm Recurrence, Local
  • Multivariate Analysis