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Clinicopathological features and medical management of intraductal papillary mucinous neoplasms.
J Gastroenterol Hepatol. 2006 Feb; 21(2):462-7.JG

Abstract

BACKGROUND

Intraductal papillary mucinous neoplasms (IPMN) are a clinicopathological entity that is being diagnosed with increasing frequency. However, the best approach to medical management of IPMN needs to be clarified. The aim of the present study was to identify preoperative features that may be predictors of malignant IPMN, and to define the medical management of IPMN of the pancreas.

METHODS

A total of 23 patients who underwent surgical resection for IPMN of the pancreas at Kochi Medical School between 1982 and 2004 were examined. Multivariate Cox regression analysis was used to identify factors independently associated with IPM carcinoma.

RESULTS

Among the 23 patients, 12 had IPMN adenoma, three had borderline IPMN, four had IPMN with carcinoma in situ, and four had IPMN with invasive carcinoma. In multivariate analysis, elevated serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels were found to be preoperative predictors of malignant IPMN. These results suggest that the following IPMN of the pancreas should be resected: (i) IPMN of the pancreas situated in the main duct; (ii) IPMN located in the branch duct if the size of the cystic lesion is >30 mm and the mural nodules are >5 mm in height by endoscopic ultrasound (EUS); and (iii) the diameter of the main pancreatic duct is >10 mm by endoscopic retrograde pancreatography (ERP). Careful observation of patients with branch-type IPMN with small cysts and/or without mural nodules is recommended as a management strategy.

CONCLUSION

The present study reinforces the need for immediate surgical resection of malignant IPMN and suggests indicators for IPMN that should assist physicians in making decisions on treatment options.

Authors+Show Affiliations

Department of Tumor Surgery, Kochi Medical School, Kochi, Japan. tokabaya@med.kochi-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16509876

Citation

Okabayashi, Takehiro, et al. "Clinicopathological Features and Medical Management of Intraductal Papillary Mucinous Neoplasms." Journal of Gastroenterology and Hepatology, vol. 21, no. 2, 2006, pp. 462-7.
Okabayashi T, Kobayashi M, Nishimori I, et al. Clinicopathological features and medical management of intraductal papillary mucinous neoplasms. J Gastroenterol Hepatol. 2006;21(2):462-7.
Okabayashi, T., Kobayashi, M., Nishimori, I., Sugimoto, T., Namikawa, T., Okamoto, K., Okamoto, N., Kosaki, T., Onishi, S., & Araki, K. (2006). Clinicopathological features and medical management of intraductal papillary mucinous neoplasms. Journal of Gastroenterology and Hepatology, 21(2), 462-7.
Okabayashi T, et al. Clinicopathological Features and Medical Management of Intraductal Papillary Mucinous Neoplasms. J Gastroenterol Hepatol. 2006;21(2):462-7. PubMed PMID: 16509876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinicopathological features and medical management of intraductal papillary mucinous neoplasms. AU - Okabayashi,Takehiro, AU - Kobayashi,Michiya, AU - Nishimori,Isao, AU - Sugimoto,Takeki, AU - Namikawa,Tsutomu, AU - Okamoto,Ken, AU - Okamoto,Nobuto, AU - Kosaki,Takuhiro, AU - Onishi,Saburo, AU - Araki,Keijiro, PY - 2006/3/3/pubmed PY - 2006/8/2/medline PY - 2006/3/3/entrez SP - 462 EP - 7 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 21 IS - 2 N2 - BACKGROUND: Intraductal papillary mucinous neoplasms (IPMN) are a clinicopathological entity that is being diagnosed with increasing frequency. However, the best approach to medical management of IPMN needs to be clarified. The aim of the present study was to identify preoperative features that may be predictors of malignant IPMN, and to define the medical management of IPMN of the pancreas. METHODS: A total of 23 patients who underwent surgical resection for IPMN of the pancreas at Kochi Medical School between 1982 and 2004 were examined. Multivariate Cox regression analysis was used to identify factors independently associated with IPM carcinoma. RESULTS: Among the 23 patients, 12 had IPMN adenoma, three had borderline IPMN, four had IPMN with carcinoma in situ, and four had IPMN with invasive carcinoma. In multivariate analysis, elevated serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels were found to be preoperative predictors of malignant IPMN. These results suggest that the following IPMN of the pancreas should be resected: (i) IPMN of the pancreas situated in the main duct; (ii) IPMN located in the branch duct if the size of the cystic lesion is >30 mm and the mural nodules are >5 mm in height by endoscopic ultrasound (EUS); and (iii) the diameter of the main pancreatic duct is >10 mm by endoscopic retrograde pancreatography (ERP). Careful observation of patients with branch-type IPMN with small cysts and/or without mural nodules is recommended as a management strategy. CONCLUSION: The present study reinforces the need for immediate surgical resection of malignant IPMN and suggests indicators for IPMN that should assist physicians in making decisions on treatment options. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/16509876/Clinicopathological_features_and_medical_management_of_intraductal_papillary_mucinous_neoplasms_ L2 - https://doi.org/10.1111/j.1440-1746.2005.03958.x DB - PRIME DP - Unbound Medicine ER -