Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas

Abstract Background Frequency and characteristics of metachronous occurrence of multifocal intraductal papillary mucinous neoplasms (IPMNs) or distinct pancreatic ductal adenocarcinomas (PDACs) in the remnant pancreas during follow-up evaluation after pancreatectomy for IPMNs have not been well know...

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Veröffentlicht in:The American journal of surgery 2012-07, Vol.204 (1), p.44-48
Hauptverfasser: Ohtsuka, Takao, M.D, Kono, Hiroshi, M.D, Tanabe, Reiko, M.D, Nagayoshi, Yosuke, M.D, Mori, Yasuhisa, M.D, Sadakari, Yoshihiko, M.D, Takahata, Shunichi, M.D, Oda, Yasunori, M.D, Aishima, Shinichi, M.D, Igarashi, Hisato, M.D, Ito, Tetsuhide, M.D, Ishigami, Kousei, M.D, Nakamura, Masafumi, M.D, Mizumoto, Kazuhiro, M.D, Tanaka, Masao, M.D
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container_end_page 48
container_issue 1
container_start_page 44
container_title The American journal of surgery
container_volume 204
creator Ohtsuka, Takao, M.D
Kono, Hiroshi, M.D
Tanabe, Reiko, M.D
Nagayoshi, Yosuke, M.D
Mori, Yasuhisa, M.D
Sadakari, Yoshihiko, M.D
Takahata, Shunichi, M.D
Oda, Yasunori, M.D
Aishima, Shinichi, M.D
Igarashi, Hisato, M.D
Ito, Tetsuhide, M.D
Ishigami, Kousei, M.D
Nakamura, Masafumi, M.D
Mizumoto, Kazuhiro, M.D
Tanaka, Masao, M.D
description Abstract Background Frequency and characteristics of metachronous occurrence of multifocal intraductal papillary mucinous neoplasms (IPMNs) or distinct pancreatic ductal adenocarcinomas (PDACs) in the remnant pancreas during follow-up evaluation after pancreatectomy for IPMNs have not been well known. The aim of this study was to investigate the outcomes after resection of IPMNs, especially focusing on the metachronous occurrence of multifocal IPMNs and distinct PDACs. Methods Medical records of 172 patients who underwent resection of IPMNs were reviewed retrospectively, and the data regarding the occurrence of metachronous IPMNs or PDACs in the remnant pancreas during a mean postoperative follow-up period of 64 months were collected. Results The incidence including synchronous and metachronous multifocal occurrence of IPMNs was 20% (34 of 172), and that of distinct PDACs was 9.9% (17 of 172). Ten metachronous IPMNs developed in the remnant pancreas after a mean time of 23 postoperative months (range, 12–84 mo), and 2 with main duct IPMNs (both were carcinoma in situ) required remnant pancreatectomy. Six distinct PDACs developed in the remnant pancreas after a mean time of 84 postoperative months (range, 12–150 mo). Four of them were found to have a tumor with a size of less than 2 cm, whereas the remaining 2 PDACs were found to be unresectable more than 10 years after resection of IPMNs. Conclusions Intense long-term follow-up evaluation is necessary for the early detection of metachronous occurrence of distinct PDACs as well as malignant IPMNs after resection of IPMNs.
doi_str_mv 10.1016/j.amjsurg.2011.04.007
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The aim of this study was to investigate the outcomes after resection of IPMNs, especially focusing on the metachronous occurrence of multifocal IPMNs and distinct PDACs. Methods Medical records of 172 patients who underwent resection of IPMNs were reviewed retrospectively, and the data regarding the occurrence of metachronous IPMNs or PDACs in the remnant pancreas during a mean postoperative follow-up period of 64 months were collected. Results The incidence including synchronous and metachronous multifocal occurrence of IPMNs was 20% (34 of 172), and that of distinct PDACs was 9.9% (17 of 172). Ten metachronous IPMNs developed in the remnant pancreas after a mean time of 23 postoperative months (range, 12–84 mo), and 2 with main duct IPMNs (both were carcinoma in situ) required remnant pancreatectomy. Six distinct PDACs developed in the remnant pancreas after a mean time of 84 postoperative months (range, 12–150 mo). Four of them were found to have a tumor with a size of less than 2 cm, whereas the remaining 2 PDACs were found to be unresectable more than 10 years after resection of IPMNs. Conclusions Intense long-term follow-up evaluation is necessary for the early detection of metachronous occurrence of distinct PDACs as well as malignant IPMNs after resection of IPMNs.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2011.04.007</identifier><identifier>PMID: 21996346</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adenocarcinoma, Mucinous - surgery ; Adult ; Aged ; Biological and medical sciences ; Carcinoma, Pancreatic Ductal - epidemiology ; Carcinoma, Pancreatic Ductal - surgery ; Carcinoma, Papillary - surgery ; Disease ; Endoscopy ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; IPMN ; Japan - epidemiology ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Magnetic resonance imaging ; Male ; Medical Records ; Medical sciences ; Metastasis ; Middle Aged ; Multifocal ; Neoplasms, Second Primary - diagnosis ; Neoplasms, Second Primary - epidemiology ; Neoplasms, Second Primary - etiology ; Pancreatectomy ; Pancreatic cancer ; Pancreatic ductal adenocarcinoma ; Pancreatic Neoplasms - epidemiology ; Pancreatic Neoplasms - surgery ; Population Surveillance ; Retrospective Studies ; Surgery ; Surveillance ; Time Factors ; Tumors</subject><ispartof>The American journal of surgery, 2012-07, Vol.204 (1), p.44-48</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c544t-e54d0e4f4c1a8e90c88d11bf461520bd8700cab301beac79eee8a13fbcee7c9e3</citedby><cites>FETCH-LOGICAL-c544t-e54d0e4f4c1a8e90c88d11bf461520bd8700cab301beac79eee8a13fbcee7c9e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1036602392?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=26017765$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21996346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ohtsuka, Takao, M.D</creatorcontrib><creatorcontrib>Kono, Hiroshi, M.D</creatorcontrib><creatorcontrib>Tanabe, Reiko, M.D</creatorcontrib><creatorcontrib>Nagayoshi, Yosuke, M.D</creatorcontrib><creatorcontrib>Mori, Yasuhisa, M.D</creatorcontrib><creatorcontrib>Sadakari, Yoshihiko, M.D</creatorcontrib><creatorcontrib>Takahata, Shunichi, M.D</creatorcontrib><creatorcontrib>Oda, Yasunori, M.D</creatorcontrib><creatorcontrib>Aishima, Shinichi, M.D</creatorcontrib><creatorcontrib>Igarashi, Hisato, M.D</creatorcontrib><creatorcontrib>Ito, Tetsuhide, M.D</creatorcontrib><creatorcontrib>Ishigami, Kousei, M.D</creatorcontrib><creatorcontrib>Nakamura, Masafumi, M.D</creatorcontrib><creatorcontrib>Mizumoto, Kazuhiro, M.D</creatorcontrib><creatorcontrib>Tanaka, Masao, M.D</creatorcontrib><title>Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Frequency and characteristics of metachronous occurrence of multifocal intraductal papillary mucinous neoplasms (IPMNs) or distinct pancreatic ductal adenocarcinomas (PDACs) in the remnant pancreas during follow-up evaluation after pancreatectomy for IPMNs have not been well known. The aim of this study was to investigate the outcomes after resection of IPMNs, especially focusing on the metachronous occurrence of multifocal IPMNs and distinct PDACs. Methods Medical records of 172 patients who underwent resection of IPMNs were reviewed retrospectively, and the data regarding the occurrence of metachronous IPMNs or PDACs in the remnant pancreas during a mean postoperative follow-up period of 64 months were collected. Results The incidence including synchronous and metachronous multifocal occurrence of IPMNs was 20% (34 of 172), and that of distinct PDACs was 9.9% (17 of 172). Ten metachronous IPMNs developed in the remnant pancreas after a mean time of 23 postoperative months (range, 12–84 mo), and 2 with main duct IPMNs (both were carcinoma in situ) required remnant pancreatectomy. Six distinct PDACs developed in the remnant pancreas after a mean time of 84 postoperative months (range, 12–150 mo). Four of them were found to have a tumor with a size of less than 2 cm, whereas the remaining 2 PDACs were found to be unresectable more than 10 years after resection of IPMNs. Conclusions Intense long-term follow-up evaluation is necessary for the early detection of metachronous occurrence of distinct PDACs as well as malignant IPMNs after resection of IPMNs.</description><subject>Adenocarcinoma, Mucinous - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Pancreatic Ductal - epidemiology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Disease</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>IPMN</subject><subject>Japan - epidemiology</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical Records</subject><subject>Medical sciences</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multifocal</subject><subject>Neoplasms, Second Primary - diagnosis</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>Neoplasms, Second Primary - etiology</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic ductal adenocarcinoma</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Population Surveillance</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surveillance</subject><subject>Time Factors</subject><subject>Tumors</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkt2K1EAQhYMo7rj6CEqDCN5krMp_EBRZXBUWvFDBu6bTqWiPSTrblazM-_lgVnZmXdgbr5qmv6pTfU5F0VOELQIWr3ZbM-x4CT-2CSBuIdsClPeiDVZlHWNVpfejDQAkcV0gnESPmHdyRczSh9FJgnVdpFmxif6c-773v-NlUjwv7V6ZbqagAjHZ2flR-U65cQ6mXexsejWZyfW9CXs1LNaNfmE1kp96w8OKzj9JkNEGMvxa8UTWSVGgjgKNlljN_poZln52nbfy2BOLDisztqqlK-r9NNA4r92OmtaEVWowMsl1daBhNILcKD2OHnSmZ3pyPE-jb-fvv559jC8-f_h09u4itnmWzTHlWQuUdZlFU1ENtqpaxKbLCswTaNqqBLCmSQEbMrasiagymHaNJSptTelp9PLQdwr-ciGe9eDYkvghHiysERLEpCxzFPT5HXTnlzDKdEKlRQFJWidC5QfKBs8sNukpuEHcFUivMeudPsas15g1ZFpilrpnx-5LM1D7r-omVwFeHAHDYnIXxCnHt1wBWJZFLtzbA0di25WjoNm6NanWBVkA3Xr331He3Olgezc6Ef1Fe-LbX2tONOgv606uK4kIkGH5Pf0Lc5PjbQ</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Ohtsuka, Takao, M.D</creator><creator>Kono, Hiroshi, M.D</creator><creator>Tanabe, Reiko, M.D</creator><creator>Nagayoshi, Yosuke, M.D</creator><creator>Mori, Yasuhisa, M.D</creator><creator>Sadakari, Yoshihiko, M.D</creator><creator>Takahata, Shunichi, M.D</creator><creator>Oda, Yasunori, M.D</creator><creator>Aishima, Shinichi, M.D</creator><creator>Igarashi, Hisato, M.D</creator><creator>Ito, Tetsuhide, M.D</creator><creator>Ishigami, Kousei, M.D</creator><creator>Nakamura, Masafumi, M.D</creator><creator>Mizumoto, Kazuhiro, M.D</creator><creator>Tanaka, Masao, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas</title><author>Ohtsuka, Takao, M.D ; Kono, Hiroshi, M.D ; Tanabe, Reiko, M.D ; Nagayoshi, Yosuke, M.D ; Mori, Yasuhisa, M.D ; Sadakari, Yoshihiko, M.D ; Takahata, Shunichi, M.D ; Oda, Yasunori, M.D ; Aishima, Shinichi, M.D ; Igarashi, Hisato, M.D ; Ito, Tetsuhide, M.D ; Ishigami, Kousei, M.D ; Nakamura, Masafumi, M.D ; Mizumoto, Kazuhiro, M.D ; Tanaka, Masao, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c544t-e54d0e4f4c1a8e90c88d11bf461520bd8700cab301beac79eee8a13fbcee7c9e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adenocarcinoma, Mucinous - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Pancreatic Ductal - epidemiology</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Disease</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Humans</topic><topic>IPMN</topic><topic>Japan - epidemiology</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical Records</topic><topic>Medical sciences</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Multifocal</topic><topic>Neoplasms, Second Primary - diagnosis</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>Neoplasms, Second Primary - etiology</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic ductal adenocarcinoma</topic><topic>Pancreatic Neoplasms - epidemiology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Population Surveillance</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surveillance</topic><topic>Time Factors</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ohtsuka, Takao, M.D</creatorcontrib><creatorcontrib>Kono, Hiroshi, M.D</creatorcontrib><creatorcontrib>Tanabe, Reiko, M.D</creatorcontrib><creatorcontrib>Nagayoshi, Yosuke, M.D</creatorcontrib><creatorcontrib>Mori, Yasuhisa, M.D</creatorcontrib><creatorcontrib>Sadakari, Yoshihiko, M.D</creatorcontrib><creatorcontrib>Takahata, Shunichi, M.D</creatorcontrib><creatorcontrib>Oda, Yasunori, M.D</creatorcontrib><creatorcontrib>Aishima, Shinichi, M.D</creatorcontrib><creatorcontrib>Igarashi, Hisato, M.D</creatorcontrib><creatorcontrib>Ito, Tetsuhide, M.D</creatorcontrib><creatorcontrib>Ishigami, Kousei, M.D</creatorcontrib><creatorcontrib>Nakamura, Masafumi, M.D</creatorcontrib><creatorcontrib>Mizumoto, Kazuhiro, M.D</creatorcontrib><creatorcontrib>Tanaka, Masao, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health &amp; 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special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>204</volume><issue>1</issue><spage>44</spage><epage>48</epage><pages>44-48</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background Frequency and characteristics of metachronous occurrence of multifocal intraductal papillary mucinous neoplasms (IPMNs) or distinct pancreatic ductal adenocarcinomas (PDACs) in the remnant pancreas during follow-up evaluation after pancreatectomy for IPMNs have not been well known. The aim of this study was to investigate the outcomes after resection of IPMNs, especially focusing on the metachronous occurrence of multifocal IPMNs and distinct PDACs. Methods Medical records of 172 patients who underwent resection of IPMNs were reviewed retrospectively, and the data regarding the occurrence of metachronous IPMNs or PDACs in the remnant pancreas during a mean postoperative follow-up period of 64 months were collected. Results The incidence including synchronous and metachronous multifocal occurrence of IPMNs was 20% (34 of 172), and that of distinct PDACs was 9.9% (17 of 172). Ten metachronous IPMNs developed in the remnant pancreas after a mean time of 23 postoperative months (range, 12–84 mo), and 2 with main duct IPMNs (both were carcinoma in situ) required remnant pancreatectomy. Six distinct PDACs developed in the remnant pancreas after a mean time of 84 postoperative months (range, 12–150 mo). Four of them were found to have a tumor with a size of less than 2 cm, whereas the remaining 2 PDACs were found to be unresectable more than 10 years after resection of IPMNs. Conclusions Intense long-term follow-up evaluation is necessary for the early detection of metachronous occurrence of distinct PDACs as well as malignant IPMNs after resection of IPMNs.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21996346</pmid><doi>10.1016/j.amjsurg.2011.04.007</doi><tpages>5</tpages></addata></record>
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source MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland
subjects Adenocarcinoma, Mucinous - surgery
Adult
Aged
Biological and medical sciences
Carcinoma, Pancreatic Ductal - epidemiology
Carcinoma, Pancreatic Ductal - surgery
Carcinoma, Papillary - surgery
Disease
Endoscopy
Female
Follow-Up Studies
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
IPMN
Japan - epidemiology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Magnetic resonance imaging
Male
Medical Records
Medical sciences
Metastasis
Middle Aged
Multifocal
Neoplasms, Second Primary - diagnosis
Neoplasms, Second Primary - epidemiology
Neoplasms, Second Primary - etiology
Pancreatectomy
Pancreatic cancer
Pancreatic ductal adenocarcinoma
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - surgery
Population Surveillance
Retrospective Studies
Surgery
Surveillance
Time Factors
Tumors
title Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas
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