Abstract
Background
The international consensus guidelines for the management of intraductal papillary mucinous neoplasm (IPMN) of the pancreas were revised in 2012 Tanaka (Pancreatology 12(3):183–197, 2012), making the indications for operation less aggressive. Therefore, the number of branch duct-type IPMN (BD-IPMN) patients requiring follow-up care is expected to increase in the future.
Methods
The aim of this study was to identify risk factors for malignancy in BD-IPMN patients during the follow-up period. This study included 47 BD-IPMN patients without a mural nodule (MN) at the time of initial diagnosis and who subsequently underwent resection after a follow-up period of more than 3 months. Data for the patients were reviewed retrospectively, and the clinicopathological factors were investigated.
Results
In a univariate analysis, age (≧65 years), an increase in the main pancreatic duct (MPD) diameter, the MPD diameter at resection (≧5 mm), and the occurrence of MN were significantly associated with malignancy. The occurrence of MN was the only significant factor in a multivariate analysis. In addition, 7 of the 17 patients (41.2 %) who only exhibited an increase in the cyst diameter during the follow-up period were diagnosed as having malignancies. All 6 patients who exhibited an increase in the cyst diameter of 100 % or more were diagnosed as having carcinoma.
Conclusions
During the follow-up period, the incidence of malignancy was higher among patients with BD-IPMNs and the occurrence of MN, an increase in the MPD diameter, or an increase ratio of 100 % or more in cyst diameter than the others; resection was recommended for these patients.
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Kato, Y., Takahashi, S., Gotohda, N. et al. Risk Factors for Malignancy in Branched-Type Intraductal Papillary Mucinous Neoplasms of the Pancreas During the Follow-Up Period. World J Surg 39, 244–250 (2015). https://doi.org/10.1007/s00268-014-2789-3
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DOI: https://doi.org/10.1007/s00268-014-2789-3