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Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery?

Cited 96 time in Web of Science Cited 118 time in Scopus
Authors
Jang, Jin-Young; Kim, Sun-Whe; Ahn, Young Joon; Yoon, Yoo-Seok; Choi, Min Gew; Lee, Kuhn Uk; Han, Joon Koo; Kim, Woo Ho; Lee, Young Joo; Kim, Song Chul; Han, Duck Jong; Kim, Yong Il; Choi, Seong Ho; Cho, Baik Hwan; Yu, Hee Chul; Yoon, Dong Sup; Lee, Woo Jung; Lee, Kyung Bum; Kim, Young Chul; Lee, Kwang Soo; Kim, Myung-Wook; Kim, Hong Jin; Kim, Hyun Jong; Park, Yong-Hyun
Issue Date
2005-04-14
Publisher
Springer Verlag
Citation
Ann Surg Oncol 2005;12:124-132
Keywords
Intraductal papillary mucinous tumorMulticenter studyMultivariate studyMalignancy prediction
Abstract
BACKGROUND: Despite recently increasing numbers of reports on intraductal papillary mucinous tumors (IPMTs), difficulties still remain in terms of diagnosis, treatment, and prognosis. The purpose of this multicenter study was to evaluate the clinicopathologic features of IPMT in Korea and to suggest predictive criteria for malignancy in IPMT. METHODS: We retrospectively reviewed the clinicopathologic data of 208 patients who underwent operations for IPMT between 1993 and 2002 at 28 institutes in Korea. RESULTS: Of the 208 patients (mean age, 61 years), 147 were men and 61 were women. A total of 124 patients underwent pancreatoduodenectomy, 42 underwent distal pancreatectomy, 17 underwent total pancreatectomy, and 25 underwent limited pancreatic resection. There were 128 benign cases (adenoma, n = 62; borderline, n = 66) and 80 malignant cases (noninvasive, n = 29; invasive, n = 51). A significant difference in 5-year survival was observed between the benign and malignant groups (92.6% vs. 65.3%; P = .006). Of the six factors (age, location, duct dilatation, mural nodule, main duct type, and tumor size) that showed statistical differences by univariate analysis between the benign and malignant groups, three were significant by multivariate analysis--namely, mural nodule (P = .009), tumor size (P = .023), and a dilated duct size (P = .010). CONCLUSIONS: A significant proportion of IPMTs are malignant, although the overall prognosis of IPMT is superior to that of ordinary pancreatic cancer. Radical surgery is recommended for IPMT with the predictors of malignancy: mural nodule, tumor size (> or =30 mm), and dilated duct size (> or =12 mm).
ISSN
1068-9265 (print)
1534-4681 (online)
Language
English
URI
https://hdl.handle.net/10371/9940
DOI
https://doi.org/10.1245/ASO.2005.02.030
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College of Medicine/School of Medicine (의과대학/대학원)Pathology (병리학전공)Journal Papers (저널논문_병리학전공)
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