Prevalence of malignancy in patients with pure main duct intraductal papillary mucinous neoplasms
| Autor: | John M. DeWitt, Stuart Sherman, Thomas F. Imperiale, C. Max Schmidt, Khaled Abdeljawad, Krishna C. Vemulapalli, Mohammad A. Al-Haddad |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty endocrine system diseases Tertiary referral hospital Malignancy Asymptomatic Risk Assessment Surgical pathology Prevalence Medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Pancreatic duct Intraductal papillary mucinous neoplasm business.industry Gastroenterology Pancreatic Ducts Retrospective cohort study medicine.disease Adenocarcinoma Mucinous Carcinoma Papillary Surgery Pancreatic Neoplasms medicine.anatomical_structure Cross-Sectional Studies Relative risk Female Radiology medicine.symptom business |
| Zdroj: | Gastrointestinal endoscopy. 79(4) |
| ISSN: | 1097-6779 |
| Popis: | Background Risk of malignancy in main duct intraductal papillary mucinous neoplasm (MD-IPMN) ranges from 36% to 100% in the literature. Although surgical resection is recommended for all MD-IPMNs, the risk of malignancy based on main pancreatic duct (MPD) size alone remains unclear. Objective To assess the prevalence of malignancy in symptomatic and asymptomatic patients with pure MD-IPMN based on MPD size. Design Single-center retrospective study of prospectively collected data. Settings Tertiary referral center. Patients and Interventions Fifty-two patients with pure low-risk MD-IPMN. Clinical, endoscopic, radiographic, and pathologic data were reviewed. Main outcome measurements Prevalence of malignancy in patients with pure MD-IPMN based on histopathology of resected lesions. Results Sixteen asymptomatic patients had pure MD-IPMN on surgical pathology, 4 (25%) with malignant disease, compared with 25 of 36 symptomatic patients (69%) with pure MD-IPMN. Logistic regression identified symptoms and MPD size as predictors of malignancy. Receiver operating characteristic curve analysis demonstrated that MPD size (optimal cutoff of 8 mm) produced the greatest area under the curve to discriminate between benign and malignant MD-IPMN (.83; 95% CI, .72-.94). MPD size greater than 8 mm has a relative risk of 2.8 for malignancy (95% CI, 1.6-4.9). Limitations Retrospective, single-center study at a tertiary referral hospital. Study population included only patients who underwent surgical resection. Conclusion Asymptomatic MD-IPMN patients with a duct size of no more than 8 mm have a lower prevalence of malignancy and may represent a distinct group of patients with less aggressive biologic behavior. Further studies are needed to confirm our observations. |
| Databáze: | OpenAIRE |
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