Intraductal papillary mucinous neoplasms: predictors of malignant and invasive pathology.
Ann Surg
; 246(4): 644-51; discussion 651-4, 2007 Oct.
Article
em En
| MEDLINE
| ID: mdl-17893501
ABSTRACT
OBJECTIVE:
Determine whether size and other preoperative parameters predict malignant or invasive intraductal papillary mucinous neoplasia (IPMN). SUMMARY BACKGROUND DATA From 1991 to 2006, 150 patients underwent 156 operations for IPMN.METHODS:
Prospectively collected, retrospective review of a single academic institution's experience. All preoperative parameters including a detailed radiologic-based classification of IPMN type, location, distribution, size, number, cytology, and mural nodularity were correlated with IPMN pathology.RESULTS:
Malignant IPMN was present in 32% of cases, whereas 19% of cases were invasive. IPMN type and main pancreatic duct diameter were significant predictors of malignant IPMN (P<0.001). Side-branch lesion number was negatively associated with invasive IPMN (P=0.03). Side-branch size, location, and distribution did not predict IPMN pathology. The presence of mural nodules was associated with malignant and invasive IPMN (P<0.001; P<0.02). Atypical cytopathology was significantly associated with malignant and invasive IPMN (P<0.001; P<0.001). Multivariate analysis demonstrated mural nodularity and atypical cytopathology were predictive of malignancy and/or invasion in branch-type IPMN.CONCLUSIONS:
To lower the rate of invasive pathology, surgery should be recommended for fit patients with main-duct IPMN and for branch-duct IPMN with mural nodularity or positive cytology irrespective of location, distribution, or size.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ductos Pancreáticos
/
Neoplasias Pancreáticas
/
Carcinoma Papilar
/
Adenocarcinoma Mucinoso
/
Carcinoma Ductal Pancreático
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos