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Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas.
Cancer. 2006 Dec 01; 107(11):2567-75.C

Abstract

BACKGROUND

Intraductal papillary mucinous neoplasm (IPMN) is a recently discovered pancreatic tumor that has continuous or discontinuous (skip) lesions. Recent reports suggest a higher frequency of cancer recurrence in the remnant pancreas after surgical resection of IPMN. It is therefore important to precisely detect intraductal cancer extension and skip lesions when resecting IPMN.

METHODS

Both intraoperative histologic examination of the surgical margin and cytologic examination of the pancreatic juice from each pancreatic segment (head, body, or tail) were performed on 43 IPMN patients. In addition to the preoperatively planned resection, 1 or 2 pancreatic segment(s) were additionally resected if the pancreatic juice tested positive in cytology. When a surgical margin was positive but the cytology in the remaining segment was negative, a subsegment (2-cm slice in width) was additionally resected until a negative margin was confirmed.

RESULTS

Twenty-five patients (58%) demonstrated negative results in both histology and cytology obtained from the segment(s) that were not initially intended to be removed. In contrast to the preoperative estimation, 5 patients were found to have a positive surgical margin and negative cytology, 5 patients demonstrated a negative surgical margin and positive cytology, and 8 patients demonstrated a positive surgical margin and positive cytology. Investigations of the resected specimens revealed that 8 patients (19%) had skip lesions in addition to the main lesion. Logistic regression analysis revealed that patients with a dilated main pancreatic duct, or those with cancerous lesions in the main tumors, were at high risk for positive histology and/or cytology.

CONCLUSIONS

Using intraoperative frozen-section histology and pancreatic juice cytology, 18 out of 43 patients in the current study (42%) required additional resection of the pancreas. A necessary and sufficient range of resection should be determined by intraoperative examination.

Authors+Show Affiliations

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. eguti-hi@mc.pref.osaka.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)

Journal Article

Language

eng

PubMed ID

17054109

Citation

Eguchi, Hidetoshi, et al. "Role of Intraoperative Cytology Combined With Histology in Detecting Continuous and Skip Type Intraductal Cancer Existence for Intraductal Papillary Mucinous Carcinoma of the Pancreas." Cancer, vol. 107, no. 11, 2006, pp. 2567-75.
Eguchi H, Ishikawa O, Ohigashi H, et al. Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas. Cancer. 2006;107(11):2567-75.
Eguchi, H., Ishikawa, O., Ohigashi, H., Sasaki, Y., Yamada, T., Nakaizumi, A., Uehara, H., Takenaka, A., Kasugai, T., & Imaoka, S. (2006). Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas. Cancer, 107(11), 2567-75.
Eguchi H, et al. Role of Intraoperative Cytology Combined With Histology in Detecting Continuous and Skip Type Intraductal Cancer Existence for Intraductal Papillary Mucinous Carcinoma of the Pancreas. Cancer. 2006 Dec 1;107(11):2567-75. PubMed PMID: 17054109.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas. AU - Eguchi,Hidetoshi, AU - Ishikawa,Osamu, AU - Ohigashi,Hiroaki, AU - Sasaki,Yo, AU - Yamada,Terumasa, AU - Nakaizumi,Akihiko, AU - Uehara,Hiroyuki, AU - Takenaka,Akemi, AU - Kasugai,Tsutomu, AU - Imaoka,Shingi, PY - 2006/10/21/pubmed PY - 2006/12/21/medline PY - 2006/10/21/entrez SP - 2567 EP - 75 JF - Cancer JO - Cancer VL - 107 IS - 11 N2 - BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is a recently discovered pancreatic tumor that has continuous or discontinuous (skip) lesions. Recent reports suggest a higher frequency of cancer recurrence in the remnant pancreas after surgical resection of IPMN. It is therefore important to precisely detect intraductal cancer extension and skip lesions when resecting IPMN. METHODS: Both intraoperative histologic examination of the surgical margin and cytologic examination of the pancreatic juice from each pancreatic segment (head, body, or tail) were performed on 43 IPMN patients. In addition to the preoperatively planned resection, 1 or 2 pancreatic segment(s) were additionally resected if the pancreatic juice tested positive in cytology. When a surgical margin was positive but the cytology in the remaining segment was negative, a subsegment (2-cm slice in width) was additionally resected until a negative margin was confirmed. RESULTS: Twenty-five patients (58%) demonstrated negative results in both histology and cytology obtained from the segment(s) that were not initially intended to be removed. In contrast to the preoperative estimation, 5 patients were found to have a positive surgical margin and negative cytology, 5 patients demonstrated a negative surgical margin and positive cytology, and 8 patients demonstrated a positive surgical margin and positive cytology. Investigations of the resected specimens revealed that 8 patients (19%) had skip lesions in addition to the main lesion. Logistic regression analysis revealed that patients with a dilated main pancreatic duct, or those with cancerous lesions in the main tumors, were at high risk for positive histology and/or cytology. CONCLUSIONS: Using intraoperative frozen-section histology and pancreatic juice cytology, 18 out of 43 patients in the current study (42%) required additional resection of the pancreas. A necessary and sufficient range of resection should be determined by intraoperative examination. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/17054109/Role_of_intraoperative_cytology_combined_with_histology_in_detecting_continuous_and_skip_type_intraductal_cancer_existence_for_intraductal_papillary_mucinous_carcinoma_of_the_pancreas_ L2 - https://doi.org/10.1002/cncr.22301 DB - PRIME DP - Unbound Medicine ER -