Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines
Purpose Although there has been considerable effort to define pre-operative features to predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs), the prognostic value of pre-operative clinical and MRI features has not been assessed. The aim of this study was to determine p...
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| Veröffentlicht in: | Abdominal imaging 2020-12, Vol.45 (12), p.4290-4301 |
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| creator | Min, Ji Hye Kim, Young Kon Kim, Honsoul Cha, Dong lk Ahn, Soohyun |
| description | Purpose
Although there has been considerable effort to define pre-operative features to predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs), the prognostic value of pre-operative clinical and MRI features has not been assessed. The aim of this study was to determine pre-operative clinical and MRI features that are predictive of disease-specific death or recurrence in patients undergoing pancreatic resection for IPMNs.
Methods
We performed a retrospective analysis of 167 patients (mean age, 65 years; 114 men and 53 women) who underwent pre-operative MRI and surgical resection of IPMN of pancreas between 2009 and 2019. We evaluated disease-specific survival (DSS) and recurrence-free survival (RFS). Prognostic factor analysis was performed using clinical and MRI features according to the 2017 international consensus guidelines.
Results
Of 167 patients, 86 (51.5%) had benign IPMNs and 81 (48.5%) had malignant IPMNs (48 [28.7%] invasive carcinoma and 33 [19.8%] high grade). On multivariable analysis, mural nodule size (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.04–1.18 and HR 1.07; 95% CI 1.03–1.12) and obstructive jaundice (HR 5.01; 95% CI 1.44–17.46 and HR 5.60; 95% CI 2.42–12.99) were the significant variables that were associated with DSS and RFS. The presence of lymphadenopathy (HR 50.7; 95% CI 4.0–643.0;
P
= 0.002) was the significant factor for DSS. IPMNs with mural nodule showed a significantly lower 5-year DSS (83.7% vs. 100%,
P
value |
| doi_str_mv | 10.1007/s00261-020-02627-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2417405109</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2417405109</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-943e0128e31ed350295e9d54a8bd64329f9c1853e54cafa4fc4252aab28faf9a3</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoMottT-ARcy4MbN1JOv-ehOSmsLBV0ouAu5mTPXlJlkmjMp3L0_vLneWsGFi5BAnvOENy9jbzmccYD2IwGIhtcgoKxGtPXuBTsWsmlqAN29fD6rH0fslOgOAHijORf6NTuSQneSy_aY_fqa4jZE8lTFsUpI6FYcKh_WZIfsVjtVi138NNm0q-bsfIiZqoBxmSzN-5n1JxYkuISWzqtMPmyL58FT0Qjg7d6FKdjVx1BsLgbCQEWyzX7AyQekN-zVaCfC06f9hH2_uvx2cV3ffvl8c_Hptnay1WvdK4nARYeS4yA1iF5jP2hlu83QKCn6sXe80xK1cna0anRKaGHtRnSjHXsrT9iHg3dJ8T4jrWb25LCEK4EyGaF4q0Bz6Av6_h_0LuaSYtpTrZSFBF4ocaBcikQJR7MkP5evMhzMviZzqMmUmszvmsyuDL17UufNjMPzyJ9SCiAPAJWrsMX09-3_aB8B5nSf3g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2473341701</pqid></control><display><type>article</type><title>Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines</title><source>Springer Nature - Complete Springer Journals</source><creator>Min, Ji Hye ; Kim, Young Kon ; Kim, Honsoul ; Cha, Dong lk ; Ahn, Soohyun</creator><creatorcontrib>Min, Ji Hye ; Kim, Young Kon ; Kim, Honsoul ; Cha, Dong lk ; Ahn, Soohyun</creatorcontrib><description>Purpose
Although there has been considerable effort to define pre-operative features to predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs), the prognostic value of pre-operative clinical and MRI features has not been assessed. The aim of this study was to determine pre-operative clinical and MRI features that are predictive of disease-specific death or recurrence in patients undergoing pancreatic resection for IPMNs.
Methods
We performed a retrospective analysis of 167 patients (mean age, 65 years; 114 men and 53 women) who underwent pre-operative MRI and surgical resection of IPMN of pancreas between 2009 and 2019. We evaluated disease-specific survival (DSS) and recurrence-free survival (RFS). Prognostic factor analysis was performed using clinical and MRI features according to the 2017 international consensus guidelines.
Results
Of 167 patients, 86 (51.5%) had benign IPMNs and 81 (48.5%) had malignant IPMNs (48 [28.7%] invasive carcinoma and 33 [19.8%] high grade). On multivariable analysis, mural nodule size (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.04–1.18 and HR 1.07; 95% CI 1.03–1.12) and obstructive jaundice (HR 5.01; 95% CI 1.44–17.46 and HR 5.60; 95% CI 2.42–12.99) were the significant variables that were associated with DSS and RFS. The presence of lymphadenopathy (HR 50.7; 95% CI 4.0–643.0;
P
= 0.002) was the significant factor for DSS. IPMNs with mural nodule showed a significantly lower 5-year DSS (83.7% vs. 100%,
P
value < 0.01) and RFS (73.1% vs. 95.0%,
P
value < 0.01) compared with IPMNs with no mural nodule.
Conclusions
Mural nodule size on MRI and obstructive jaundice were prognostic markers in the pre-operative evaluation of patients with IPMN of pancreas.</description><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-020-02627-y</identifier><identifier>PMID: 32583137</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Confidence intervals ; Evaluation ; Factor analysis ; Gastroenterology ; Guidelines ; Hepatology ; Imaging ; Invasiveness ; Jaundice ; Lymphadenopathy ; Magnetic resonance imaging ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neoplasms ; Pancreas ; Pancreatic cancer ; Radiology ; Survival</subject><ispartof>Abdominal imaging, 2020-12, Vol.45 (12), p.4290-4301</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-943e0128e31ed350295e9d54a8bd64329f9c1853e54cafa4fc4252aab28faf9a3</citedby><cites>FETCH-LOGICAL-c375t-943e0128e31ed350295e9d54a8bd64329f9c1853e54cafa4fc4252aab28faf9a3</cites><orcidid>0000-0002-6854-400X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00261-020-02627-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00261-020-02627-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32583137$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Min, Ji Hye</creatorcontrib><creatorcontrib>Kim, Young Kon</creatorcontrib><creatorcontrib>Kim, Honsoul</creatorcontrib><creatorcontrib>Cha, Dong lk</creatorcontrib><creatorcontrib>Ahn, Soohyun</creatorcontrib><title>Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
Although there has been considerable effort to define pre-operative features to predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs), the prognostic value of pre-operative clinical and MRI features has not been assessed. The aim of this study was to determine pre-operative clinical and MRI features that are predictive of disease-specific death or recurrence in patients undergoing pancreatic resection for IPMNs.
Methods
We performed a retrospective analysis of 167 patients (mean age, 65 years; 114 men and 53 women) who underwent pre-operative MRI and surgical resection of IPMN of pancreas between 2009 and 2019. We evaluated disease-specific survival (DSS) and recurrence-free survival (RFS). Prognostic factor analysis was performed using clinical and MRI features according to the 2017 international consensus guidelines.
Results
Of 167 patients, 86 (51.5%) had benign IPMNs and 81 (48.5%) had malignant IPMNs (48 [28.7%] invasive carcinoma and 33 [19.8%] high grade). On multivariable analysis, mural nodule size (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.04–1.18 and HR 1.07; 95% CI 1.03–1.12) and obstructive jaundice (HR 5.01; 95% CI 1.44–17.46 and HR 5.60; 95% CI 2.42–12.99) were the significant variables that were associated with DSS and RFS. The presence of lymphadenopathy (HR 50.7; 95% CI 4.0–643.0;
P
= 0.002) was the significant factor for DSS. IPMNs with mural nodule showed a significantly lower 5-year DSS (83.7% vs. 100%,
P
value < 0.01) and RFS (73.1% vs. 95.0%,
P
value < 0.01) compared with IPMNs with no mural nodule.
Conclusions
Mural nodule size on MRI and obstructive jaundice were prognostic markers in the pre-operative evaluation of patients with IPMN of pancreas.</description><subject>Confidence intervals</subject><subject>Evaluation</subject><subject>Factor analysis</subject><subject>Gastroenterology</subject><subject>Guidelines</subject><subject>Hepatology</subject><subject>Imaging</subject><subject>Invasiveness</subject><subject>Jaundice</subject><subject>Lymphadenopathy</subject><subject>Magnetic resonance imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasms</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Radiology</subject><subject>Survival</subject><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU1rFTEUhoMottT-ARcy4MbN1JOv-ehOSmsLBV0ouAu5mTPXlJlkmjMp3L0_vLneWsGFi5BAnvOENy9jbzmccYD2IwGIhtcgoKxGtPXuBTsWsmlqAN29fD6rH0fslOgOAHijORf6NTuSQneSy_aY_fqa4jZE8lTFsUpI6FYcKh_WZIfsVjtVi138NNm0q-bsfIiZqoBxmSzN-5n1JxYkuISWzqtMPmyL58FT0Qjg7d6FKdjVx1BsLgbCQEWyzX7AyQekN-zVaCfC06f9hH2_uvx2cV3ffvl8c_Hptnay1WvdK4nARYeS4yA1iF5jP2hlu83QKCn6sXe80xK1cna0anRKaGHtRnSjHXsrT9iHg3dJ8T4jrWb25LCEK4EyGaF4q0Bz6Av6_h_0LuaSYtpTrZSFBF4ocaBcikQJR7MkP5evMhzMviZzqMmUmszvmsyuDL17UufNjMPzyJ9SCiAPAJWrsMX09-3_aB8B5nSf3g</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Min, Ji Hye</creator><creator>Kim, Young Kon</creator><creator>Kim, Honsoul</creator><creator>Cha, Dong lk</creator><creator>Ahn, Soohyun</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6854-400X</orcidid></search><sort><creationdate>20201201</creationdate><title>Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines</title><author>Min, Ji Hye ; Kim, Young Kon ; Kim, Honsoul ; Cha, Dong lk ; Ahn, Soohyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-943e0128e31ed350295e9d54a8bd64329f9c1853e54cafa4fc4252aab28faf9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Confidence intervals</topic><topic>Evaluation</topic><topic>Factor analysis</topic><topic>Gastroenterology</topic><topic>Guidelines</topic><topic>Hepatology</topic><topic>Imaging</topic><topic>Invasiveness</topic><topic>Jaundice</topic><topic>Lymphadenopathy</topic><topic>Magnetic resonance imaging</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasms</topic><topic>Pancreas</topic><topic>Pancreatic cancer</topic><topic>Radiology</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Min, Ji Hye</creatorcontrib><creatorcontrib>Kim, Young Kon</creatorcontrib><creatorcontrib>Kim, Honsoul</creatorcontrib><creatorcontrib>Cha, Dong lk</creatorcontrib><creatorcontrib>Ahn, Soohyun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Min, Ji Hye</au><au>Kim, Young Kon</au><au>Kim, Honsoul</au><au>Cha, Dong lk</au><au>Ahn, Soohyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>45</volume><issue>12</issue><spage>4290</spage><epage>4301</epage><pages>4290-4301</pages><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
Although there has been considerable effort to define pre-operative features to predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs), the prognostic value of pre-operative clinical and MRI features has not been assessed. The aim of this study was to determine pre-operative clinical and MRI features that are predictive of disease-specific death or recurrence in patients undergoing pancreatic resection for IPMNs.
Methods
We performed a retrospective analysis of 167 patients (mean age, 65 years; 114 men and 53 women) who underwent pre-operative MRI and surgical resection of IPMN of pancreas between 2009 and 2019. We evaluated disease-specific survival (DSS) and recurrence-free survival (RFS). Prognostic factor analysis was performed using clinical and MRI features according to the 2017 international consensus guidelines.
Results
Of 167 patients, 86 (51.5%) had benign IPMNs and 81 (48.5%) had malignant IPMNs (48 [28.7%] invasive carcinoma and 33 [19.8%] high grade). On multivariable analysis, mural nodule size (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.04–1.18 and HR 1.07; 95% CI 1.03–1.12) and obstructive jaundice (HR 5.01; 95% CI 1.44–17.46 and HR 5.60; 95% CI 2.42–12.99) were the significant variables that were associated with DSS and RFS. The presence of lymphadenopathy (HR 50.7; 95% CI 4.0–643.0;
P
= 0.002) was the significant factor for DSS. IPMNs with mural nodule showed a significantly lower 5-year DSS (83.7% vs. 100%,
P
value < 0.01) and RFS (73.1% vs. 95.0%,
P
value < 0.01) compared with IPMNs with no mural nodule.
Conclusions
Mural nodule size on MRI and obstructive jaundice were prognostic markers in the pre-operative evaluation of patients with IPMN of pancreas.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32583137</pmid><doi>10.1007/s00261-020-02627-y</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-6854-400X</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Confidence intervals Evaluation Factor analysis Gastroenterology Guidelines Hepatology Imaging Invasiveness Jaundice Lymphadenopathy Magnetic resonance imaging Medical prognosis Medicine Medicine & Public Health Neoplasms Pancreas Pancreatic cancer Radiology Survival |
| title | Prognosis of resected intraductal papillary mucinous neoplasm of the pancreas: using revised 2017 international consensus guidelines |
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