Patterns of recurrence and long-term outcomes in patients who underwent pancreatectomy for intraductal papillary mucinous neoplasms with high grade dysplasia: implications for surveillance and future management guidelines

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Aaron U BlackhamPamela Hodul

Abstract

While intraductal papillary mucinous neoplasms (IPMNs) with high-grade dysplasia (HGD) are thought to represent non-invasive, high-risk lesions, its natural history following resection is unknown. A retrospective review of HGD-IPMN patients (1999-2015) was performed. Recurrence patterns and clinical outcomes following pancreatectomy were analyzed and the indications for surgery were explored based on current guidelines. HGD was diagnosed in 100 of 314 patients (32%) following pancreatectomy for IPMN. IPMNs were classified as main duct, branch duct, or mixed in 15, 58 and 27 patients, respectively. Following resection, 25 patients had low-risk residual disease in the remnant pancreas. With a median follow-up of 35 months (range 1-129), 9 patients developed progressive or recurrent disease, 4 of whom underwent additional pancreatectomy. Three patients developed invasive adenocarcinoma. Median time to recurrence was 15 months (range 7-72). Based on the management algorithm from the international consensus guidelines, resection was indicated in 76 patients (76%). Other indications for surgery included mixed-duct IPMN(13), increased cyst size(7) and other(4). The prognosis of HGD-IPMN following resection is good; however, HGD may be...Continue Reading

Citations

Apr 21, 2018·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Ken KamataMasatoshi Kudo
Apr 22, 2020·Journal of Pathology and Translational Medicine·Miseon LeeKyung-Ja Cho
Sep 19, 2019·Nature Reviews. Gastroenterology & Hepatology·Nadine C M van HuijgevoortMarc G Besselink
Jan 4, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Rachel E SimpsonC Max Schmidt
Nov 24, 2018·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Claudio LuchiniRita T Lawlor

❮ Previous
Next ❯

Related Concepts

Related Feeds

Astrocytes

Astrocytes are glial cells that support the blood-brain barrier, facilitate neurotransmission, provide nutrients to neurons, and help repair damaged nervous tissues. Here is the latest research.