Article

Annals of Surgical Oncology

, Volume 12, Issue 2, pp 124-132

Multicenter Analysis of Clinicopathologic Features of Intraductal Papillary Mucinous Tumor of the Pancreas: Is It Possible to Predict the Malignancy Before Surgery?

  • Jin-Young JangAffiliated withDepartment of Surgery, Seoul National University Hospital
  • , Sun-Whe KimAffiliated withDepartment of Surgery, Seoul National University Hospital Email author 
  • , Young Joon AhnAffiliated withDepartment of Surgery, Seoul National University Hospital
  • , Yoo-Seok YoonAffiliated withDepartment of Surgery, Seoul National University Hospital
  • , Min Gew ChoiAffiliated withDepartment of Surgery, Seoul National University Hospital
  • , Kuhn Uk LeeAffiliated withDepartment of Surgery, Seoul National University Hospital
  • , Joon Koo HanAffiliated withDepartment of Radiology, Seoul National University
  • , Woo Ho KimAffiliated withDepartment of Pathology, Seoul National University
  • , Young Joo LeeAffiliated withDepartment of Surgery, Ulsan University
    • , Song Chul KimAffiliated withDepartment of Surgery, Ulsan University
    • , Duck Jong HanAffiliated withDepartment of Surgery, Ulsan University
    • , Yong Il KimAffiliated withDepartment of Surgery, Sungkyunkwan University
    • , Seong Ho ChoiAffiliated withDepartment of Surgery, Sungkyunkwan University
    • , Baik Hwan ChoAffiliated withDepartment of Surgery, Chonbuk National University
    • , Hee Chul YuAffiliated withDepartment of Surgery, Chonbuk National University
    • , Dong Sup YoonAffiliated withDepartment of Surgery, Yonsei University
    • , Woo Jung LeeAffiliated withDepartment of Surgery, Yonsei University
    • , Kyung Bum LeeAffiliated withDepartment of Surgery, Korea University
    • , Young Chul KimAffiliated withDepartment of Surgery, Korea University
    • , Kwang Soo LeeAffiliated withDepartment of Surgery, Hanyang University
    • , Myung-Wook KimAffiliated withDepartment of Surgery, Seoul National University Hospital
    • , Hong Jin KimAffiliated withDepartment of Surgery, Seoul National University HospitalDepartment of Surgery, Yeungnam University
    • , Hyun Jong KimAffiliated withDepartment of Surgery, Seoul National University HospitalDepartment of Surgery, Chonnam National University
    • , Yong-Hyun ParkAffiliated withDepartment of Surgery, Seoul National University Hospital

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Abstract

Background

Despite recently increasing numbers of reports on intraductal papillary mucinous tumors (IPMTs), difficulties still remain in terms of diagnosis, treatment, and prognosis. The purpose of this multicenter study was to evaluate the clinicopathologic features of IPMT in Korea and to suggest predictive criteria for malignancy in IPMT.

Methods

We retrospectively reviewed the clinicopathologic data of 208 patients who underwent operations for IPMT between 1993 and 2002 at 28 institutes in Korea.

Results

Of the 208 patients (mean age, 61 years), 147 were men and 61 were women. A total of 124 patients underwent pancreatoduodenectomy, 42 underwent distal pancreatectomy, 17 underwent total pancreatectomy, and 25 underwent limited pancreatic resection. There were 128 benign cases (adenoma, n = 62; borderline, n = 66) and 80 malignant cases (noninvasive, n = 29; invasive, n = 51). A significant difference in 5-year survival was observed between the benign and malignant groups (92.6% vs. 65.3%; P = .006). Of the six factors (age, location, duct dilatation, mural nodule, main duct type, and tumor size) that showed statistical differences by univariate analysis between the benign and malignant groups, three were significant by multivariate analysis—namely, mural nodule (P = .009), tumor size (P = .023), and a dilated duct size (P = .010).

Conclusions

A significant proportion of IPMTs are malignant, although the overall prognosis of IPMT is superior to that of ordinary pancreatic cancer. Radical surgery is recommended for IPMT with the predictors of malignancy: mural nodule, tumor size (⩾30 mm), and dilated duct size (⩾12 mm).

Keywords

Intraductal papillary mucinous tumor Multicenter study Multivariate study Malignancy prediction