Prevalence of malignancy in patients with pure main duct intraductal papillary mucinous neoplasms

Abdeljawad, Khaled; Vemulapalli, Krishna C.; Schmidt, C. Max; DeWitt, John M.; Sherman, Stuart; Imperiale, Thomas F.; Al‐Haddad, Mohammad

doi:10.1016/j.gie.2013.08.024

Cited by 40 publications

(28 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Regardless of the specific limit, a dilated MPD alone is currently considered a major indicator for surgical resection owing to the high risk of malignancy. Consistent with these recommendations, several surgical series have reported relevant rates of cancer in IPMNs when the MPD is between 5 and 9 mm.…”

Section: Introductionmentioning

confidence: 62%

“…The aim of these guidelines is to characterize the risk of malignant progression of IPMNs, identifying patients who require preventive surgical treatment before developing pancreatic cancer. IPMNs of secondary ducts are associated with a low risk of malignant progression; however, those with involvement of the main pancreatic duct (MPD) have a significantly higher risk. The international guidelines recommend surgery for patients with a MPD of 10 mm or larger, whereas for those with a MPD between 5 and 9 mm the indication is to proceed with endoscopic ultrasonography (EUS) to better define the risk of malignancy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Importance of main pancreatic duct dilatation in IPMN undergoing surveillance

Marchegiani

Andrianello

Morbin

et al. 2018

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Importance of main pancreatic duct dilatation in IPMN undergoing surveillance

Marchegiani

Andrianello

Morbin

et al. 2018

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…These are previously reported predictive factors with high specificity for malignant MD-IPMNs. 8,29,30,33,34 However, almost 70% of patients with high-grade dysplasia presented with a level of CA 19.9 under the normal threshold of 37 U/mL, demonstrating the low sensitivity of the biomarker in this setting.…”

Section: Discussionmentioning

confidence: 99%

IPMN Involving the Main Pancreatic Duct

et al. 2015

View full text Add to dashboard Cite

Objectives To describe the characteristics of intraductal papillary mucinous neoplasms (IPMNs) with predominant involvement of the main pancreatic duct (MPD), analyzing predictors for survival and recurrence. Background IPMNs involving the MPD harbor a high likelihood of malignancy and different biological features. The appropriateness of including cases with minimal noncircumferential MPD involvement has been challenged because these show clinicopathological features that are similar to branch duct IPMN. Accordingly, their exclusion has led to a redefinition of MPD IPMN (MD-IPMN). Methods Retrospective review of resected MD-IPMN from 1990 to 2013. All slides were reviewed by a single pancreatic pathologist and classified on the basis of epithelial type and invasive component. Results A total of 223 patients underwent resection for IPMN involving the MPD. Of these, 50 were excluded because of minimal MPD involvement. Among the 173 patients analyzed, median age was 68 years and 55% were males. Predominant epithelial phenotype was intestinal (50%). Forty-eight patients (28%) had low- or intermediate-grade dysplasia, whereas 125 (72%) had either high-grade dysplasia (33%) or invasive carcinoma (39%). Of the 67 invasive IPMNs, 39 were tubular carcinomas (58%) and invasion was minimal (<5 mm) in 28 (42%). The 5-year overall survival rate was 69% and the disease-specific survival rate was 83%. The estimated recurrence rate at 10 years was 25%. Size and type of the invasive component, lymph node positivity, and a positive resection margin were predictors for both survival and recurrence (P < 0.05). Conclusions MD-IPMN is mainly intestinal-type and malignant. After resection, it has a very favorable prognosis, especially in the absence of macroscopic invasive carcinoma.

show abstract

“…Duct diameter more than 8 mm yielded the highest area under the curve of 0.83 for diagnosing malignancy in 52 resected main duct-IPMNs [49]. Duct diameter more than 8 mm yielded the highest area under the curve of 0.83 for diagnosing malignancy in 52 resected main duct-IPMNs [49].…”

Section: Is the Cyst Malignant?mentioning

confidence: 98%