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Incidentally Discovered Pancreatic Intraepithelial Neoplasia: What Is Its Clinical Significance?

  • Pancreatic Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Pancreatic intraepithelial neoplasia (PanIN) is a presumed precursor of pancreatic ductal adenocarcinoma (PDAC). We assessed the relationship between incidental PanIN after resection of non-adenocarcinoma lesions and the development of metachronous PDAC in the remnant.

Methods

We retrospectively reviewed the clinicopathologic data of patients who underwent pancreatectomy for non-PDAC from January 2000 to January 2010. Intraductal papillary mucinous lesions were excluded. All available postoperative imaging and clinical follow-up data were reviewed; the risk of developing PDAC was assessed in patients with a minimum follow-up time of 6 months and with imaging studies available for review.

Results

A total of 584 patients were analyzed. Median age was 59 years (range 10–85 years), and 338 (58 %) were female. The most common lesions for which resection was performed were serous cystic neoplasms (17 %), pancreatic neuroendocrine tumors (38 %), metastatic tumors (9 %), and mucinous cystic neoplasms (7 %). PanIN was identified in 153 (26 %) patients. The majority of these patients had PanIN-1 or -2 (50 and 41 %, respectively), whereas 13 (8 %) had PanIN-3. Of the 506 (87 %) patients with adequate follow-up (median 3.7 years, range 0.5–12.6 years), 1 patient (0.2 %) with PanIN identified at the time of initial resection developed cancer in the remnant. This occurred 4.4 years after a distal pancreatectomy in the setting of PanIN-1B. No patient with PanIN-3 developed cancer during follow-up.

Conclusions

PanIN was identified in 26 % of patients who underwent resection for histopathology other than PDAC. The presence of PanIN of any grade did not result in an appreciable cancer risk in the pancreatic remnant after short-term follow-up.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Ioannis T. Konstantinidis MD, Eduardo F. Vinuela MD, Michael I. D’Angelica MD, Ronald P. DeMatteo MD, T. Peter Kingham MD, Yuman Fong MD, William R. Jarnagin MD & Peter J. Allen MD

  2. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Laura H. Tang MD & David S. Klimstra MD

Authors
  1. Ioannis T. Konstantinidis MD
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  2. Eduardo F. Vinuela MD
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  3. Laura H. Tang MD
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  4. David S. Klimstra MD
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  5. Michael I. D’Angelica MD
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  6. Ronald P. DeMatteo MD
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  7. T. Peter Kingham MD
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  8. Yuman Fong MD
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  9. William R. Jarnagin MD
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  10. Peter J. Allen MD
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Corresponding author

Correspondence to Peter J. Allen MD.

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Konstantinidis, I.T., Vinuela, E.F., Tang, L.H. et al. Incidentally Discovered Pancreatic Intraepithelial Neoplasia: What Is Its Clinical Significance?. Ann Surg Oncol 20, 3643–3647 (2013). https://doi.org/10.1245/s10434-013-3042-2

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  • DOI: https://doi.org/10.1245/s10434-013-3042-2

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