Abstract
Although treatment methods for the positive margins of surgically treated intraductal papillary mucinous neoplasms (IPMNs) are established, the significance of the positive surgical margins remains unclear. We aimed to clarify the risk factors of the positive margins and their impact on the recurrence of cystic lesions. Fifty-five surgically treated IPMN cases occurring at the Ogaki Municipal Hospital from 2004 to 2013 were analyzed retrospectively. Out of the 55 IPMN patients who underwent pancreatectomy, positive surgical margins were found in 16 cases. Most of the positive surgical margin cases were found to be a multifocal IPMN; specifically, 9 out of 19 were a multifocal IPMN case, and 7 out of 36 were a unifocal IPMN case (47.4% and 19.4%, respectively, p = 0.030). Recurrences of cystic lesions in the remnant pancreases were found in 7 cases; 4 out of 16 cases were in the positive margin group, and 3 out of 39 were in the negative margin group (25.0% and 7.7%, respectively, p = 0.080). While a positive margin was a significant risk factor in unifocal IPMN (p = 0.031), it was not in multifocal IPMN (p = 0.90). Positive surgical margins are frequently found in multifocal IPMNs and might include false positive margins.
References
Aug 29, 2001·Annals of Surgery·T A SohnK D Lillemoe
Dec 18, 2001·Cancer·T IzawaY Kohgo
Apr 8, 2004·International Journal of Cancer. Journal International Du Cancer·Minoru KitagoMasaki Kitajima
Dec 6, 2005·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Masao TanakaUNKNOWN International Association of Pancreatology
Mar 9, 2006·Annals of Surgical Oncology·Chandrajit P RautDouglas B Evans
Mar 22, 2006·Cancer·Paul J MichaelsMartha Bishop Pitman
Mar 17, 2007·Cancer Cell International·Gabriel D DakuboRyan L Parr
May 8, 2007·Journal of the American College of Surgeons·Rebekah WhitePeter Allen
Jul 17, 2007·Gastroenterology·J Ruben RodriguezCarlos Fernández-Del Castillo
Mar 12, 2008·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·J Bendix HolmeA Kruse
Jul 18, 2008·Radiology·Hiroshi OgawaShinji Naganawa
Aug 1, 2008·World Journal of Surgery·Marco NiedergethmannHans-Detlev Saeger
Oct 27, 2009·Journal of the American College of Surgeons·Satoshi NaraNobuyoshi Hiraoka
Feb 10, 2010·Annals of Surgery·George A PoultsidesChristopher L Wolfgang
May 4, 2010·Surgery·Tsutomu FujiiAkimasa Nakao
Apr 22, 2011·Gut·Mari Mino-KenudsonSarah P Thayer
Jul 23, 2011·Human Pathology·Chanjuan Shi, Ralph H Hruban
Nov 15, 2011·Pancreas·Guillaume PassotMustapha Adham
Dec 15, 2011·Annals of Surgery·Hanno MatthaeiRalph H Hruban
May 29, 2012·Ultrasound Quarterly·Joseph ReisSusan Voci
Feb 12, 2013·Journal of the American College of Surgeons·Jin HeChristopher L Wolfgang
Jun 21, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Timothy L FrankelPeter J Allen
Citations
Mar 27, 2018·Gut·UNKNOWN European Study Group on Cystic Tumours of the Pancreas
Aug 1, 2018·Annals of Surgery·Vikrom K DharSyed A Ahmad
Sep 19, 2019·Nature Reviews. Gastroenterology & Hepatology·Nadine C M van HuijgevoortMarc G Besselink