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 (⩾30 mm), and dilated duct size (⩾12 mm).
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Acknowledgments
The authors thank Drs. Young Kook Yun (Kyungpook National University); Soon Chan Hong (Gyengsang National University); Koo Jeong Kang (Keimyung University); Kyong Woo Choi (National Medical Center); Yong Oon Yoo (Catholic University of Daegu); Jong Hun Park (Daegu Fatima Hospital); Young Hoon Kim (Dong-A University); Mun Sup Sim (Pusan National University); Hyung Chul Kim, Chang Ho Kim, and Man Kyu Chae (Soonchunhyang University); Hong Yong Kim and Young Gil Choi (Inje University); Kwon Mook Chae (Wonkwang University); Dong Wook Choi (Korea Cancer Center Hospital); Ho Seong Han (Ewha Women University); Seung Ik Ahn (Inha University); Kuk Hwan Kwon (National Health Insurance Corporation Ilsan Hospital); Jae Woon Choi (Chungbuk National University); Jong Riul Lee (Cheonju St. Mary’s Hospital); and Joo Seop Kim (Hallym University) for their cooperation in the conduction this study. They generously provided important clinicopathologic information about patients with IPMT.
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Jang, JY., Kim, SW., Ahn, Y.J. et al. Multicenter Analysis of Clinicopathologic Features of Intraductal Papillary Mucinous Tumor of the Pancreas: Is It Possible to Predict the Malignancy Before Surgery?. Ann Surg Oncol 12, 124–132 (2005). https://doi.org/10.1245/ASO.2005.02.030
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DOI: https://doi.org/10.1245/ASO.2005.02.030