Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas

Hidetoshi Eguchi, Osarnu Ishikawa, Hiroaki Ohigashi, Yo Sasaki, Terumasa Yamada, Akihiko Nakaizumi, Hiroyuki Uehara, Akemi Takenaka, Tsutomu Kasugai, Shingi Imaoka

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

BACKGROUND. Intraductal papillary mucinous neoplasm (IPMN) is a recently discovered pancreatic tumor that has continuous or discontinuous (skip) lesions. Recent reports suggest a higher frequency of cancer recurrence in the remnant pancreas after surgical resection of IPMN. It is therefore important to precisely detect intraductal cancer extension and skip lesions when resecting IPMN. METHODS. Both intraoperative histologic examination of the surgical margin and cytologic examination of the pancreatic juice from each pancreatic segment (head, body, or tail) were performed on 43 IPMN patients. In addition to the preoperatively planned resection, 1 or 2 pancreatic segment(s) were additionally resected if the pancreatic juice tested positive in cytology. When a surgical margin was positive hut the cytology in the remaining segment was negative, a subsegment (2-cm slice in width) was additionally resected until a negative margin was confirmed. RESULTS. Twenty-five patients (58%) demonstrated negative results in both histology and cytology obtained from the segment(s) that were not initially intended to be removed. In contrast to the preoperative estimation, 5 patients were found to have a positive surgical margin and negative cytology, 5 patients demonstrated a negative surgical margin and positive cytology, and 8 patients demonstrated a positive surgical margin and positive cytology. Investigations of the resected specimens revealed that 8 patients (19%) had skip lesions in addition to the main lesion. Logistic regression analysis revealed that patients with a dilated main pancreatic duct, or those with cancerous lesions in the main tumors, were at high risk for positive histology and/or cytology. CONCLUSIONS. Using intraoperative frozen-section histology and pancreatic juice cytology, 18 out of 43 patients in the current study (42%) required additional resection of the pancreas. A necessary and sufficient range of resection should be determined by intraoperative examination.

Original languageEnglish
Pages (from-to)2567-2575
Number of pages9
JournalCancer
Volume107
Issue number11
DOIs
Publication statusPublished - Dec 1 2006

Fingerprint

Mucinous Adenocarcinoma
Carcinoma, Intraductal, Noninfiltrating
Papillary Carcinoma
Cell Biology
Pancreas
Histology
Pancreatic Juice
Neoplasms
Pancreatic Ducts
Frozen Sections
Logistic Models
Head
Regression Analysis
Margins of Excision
Recurrence

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas. / Eguchi, Hidetoshi; Ishikawa, Osarnu; Ohigashi, Hiroaki; Sasaki, Yo; Yamada, Terumasa; Nakaizumi, Akihiko; Uehara, Hiroyuki; Takenaka, Akemi; Kasugai, Tsutomu; Imaoka, Shingi.

In: Cancer, Vol. 107, No. 11, 01.12.2006, p. 2567-2575.

Research output: Contribution to journalArticle

Eguchi, H, Ishikawa, O, Ohigashi, H, Sasaki, Y, Yamada, T, Nakaizumi, A, Uehara, H, Takenaka, A, Kasugai, T & Imaoka, S 2006, 'Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas', Cancer, vol. 107, no. 11, pp. 2567-2575. https://doi.org/10.1002/cncr.22301
Eguchi, Hidetoshi ; Ishikawa, Osarnu ; Ohigashi, Hiroaki ; Sasaki, Yo ; Yamada, Terumasa ; Nakaizumi, Akihiko ; Uehara, Hiroyuki ; Takenaka, Akemi ; Kasugai, Tsutomu ; Imaoka, Shingi. / Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas. In: Cancer. 2006 ; Vol. 107, No. 11. pp. 2567-2575.
@article{240176cdd6664260a5488d02c059cd47,
title = "Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas",
abstract = "BACKGROUND. Intraductal papillary mucinous neoplasm (IPMN) is a recently discovered pancreatic tumor that has continuous or discontinuous (skip) lesions. Recent reports suggest a higher frequency of cancer recurrence in the remnant pancreas after surgical resection of IPMN. It is therefore important to precisely detect intraductal cancer extension and skip lesions when resecting IPMN. METHODS. Both intraoperative histologic examination of the surgical margin and cytologic examination of the pancreatic juice from each pancreatic segment (head, body, or tail) were performed on 43 IPMN patients. In addition to the preoperatively planned resection, 1 or 2 pancreatic segment(s) were additionally resected if the pancreatic juice tested positive in cytology. When a surgical margin was positive hut the cytology in the remaining segment was negative, a subsegment (2-cm slice in width) was additionally resected until a negative margin was confirmed. RESULTS. Twenty-five patients (58{\%}) demonstrated negative results in both histology and cytology obtained from the segment(s) that were not initially intended to be removed. In contrast to the preoperative estimation, 5 patients were found to have a positive surgical margin and negative cytology, 5 patients demonstrated a negative surgical margin and positive cytology, and 8 patients demonstrated a positive surgical margin and positive cytology. Investigations of the resected specimens revealed that 8 patients (19{\%}) had skip lesions in addition to the main lesion. Logistic regression analysis revealed that patients with a dilated main pancreatic duct, or those with cancerous lesions in the main tumors, were at high risk for positive histology and/or cytology. CONCLUSIONS. Using intraoperative frozen-section histology and pancreatic juice cytology, 18 out of 43 patients in the current study (42{\%}) required additional resection of the pancreas. A necessary and sufficient range of resection should be determined by intraoperative examination.",
author = "Hidetoshi Eguchi and Osarnu Ishikawa and Hiroaki Ohigashi and Yo Sasaki and Terumasa Yamada and Akihiko Nakaizumi and Hiroyuki Uehara and Akemi Takenaka and Tsutomu Kasugai and Shingi Imaoka",
year = "2006",
month = "12",
day = "1",
doi = "10.1002/cncr.22301",
language = "English",
volume = "107",
pages = "2567--2575",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "11",

}

TY - JOUR

T1 - Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas

AU - Eguchi, Hidetoshi

AU - Ishikawa, Osarnu

AU - Ohigashi, Hiroaki

AU - Sasaki, Yo

AU - Yamada, Terumasa

AU - Nakaizumi, Akihiko

AU - Uehara, Hiroyuki

AU - Takenaka, Akemi

AU - Kasugai, Tsutomu

AU - Imaoka, Shingi

PY - 2006/12/1

Y1 - 2006/12/1

N2 - BACKGROUND. Intraductal papillary mucinous neoplasm (IPMN) is a recently discovered pancreatic tumor that has continuous or discontinuous (skip) lesions. Recent reports suggest a higher frequency of cancer recurrence in the remnant pancreas after surgical resection of IPMN. It is therefore important to precisely detect intraductal cancer extension and skip lesions when resecting IPMN. METHODS. Both intraoperative histologic examination of the surgical margin and cytologic examination of the pancreatic juice from each pancreatic segment (head, body, or tail) were performed on 43 IPMN patients. In addition to the preoperatively planned resection, 1 or 2 pancreatic segment(s) were additionally resected if the pancreatic juice tested positive in cytology. When a surgical margin was positive hut the cytology in the remaining segment was negative, a subsegment (2-cm slice in width) was additionally resected until a negative margin was confirmed. RESULTS. Twenty-five patients (58%) demonstrated negative results in both histology and cytology obtained from the segment(s) that were not initially intended to be removed. In contrast to the preoperative estimation, 5 patients were found to have a positive surgical margin and negative cytology, 5 patients demonstrated a negative surgical margin and positive cytology, and 8 patients demonstrated a positive surgical margin and positive cytology. Investigations of the resected specimens revealed that 8 patients (19%) had skip lesions in addition to the main lesion. Logistic regression analysis revealed that patients with a dilated main pancreatic duct, or those with cancerous lesions in the main tumors, were at high risk for positive histology and/or cytology. CONCLUSIONS. Using intraoperative frozen-section histology and pancreatic juice cytology, 18 out of 43 patients in the current study (42%) required additional resection of the pancreas. A necessary and sufficient range of resection should be determined by intraoperative examination.

AB - BACKGROUND. Intraductal papillary mucinous neoplasm (IPMN) is a recently discovered pancreatic tumor that has continuous or discontinuous (skip) lesions. Recent reports suggest a higher frequency of cancer recurrence in the remnant pancreas after surgical resection of IPMN. It is therefore important to precisely detect intraductal cancer extension and skip lesions when resecting IPMN. METHODS. Both intraoperative histologic examination of the surgical margin and cytologic examination of the pancreatic juice from each pancreatic segment (head, body, or tail) were performed on 43 IPMN patients. In addition to the preoperatively planned resection, 1 or 2 pancreatic segment(s) were additionally resected if the pancreatic juice tested positive in cytology. When a surgical margin was positive hut the cytology in the remaining segment was negative, a subsegment (2-cm slice in width) was additionally resected until a negative margin was confirmed. RESULTS. Twenty-five patients (58%) demonstrated negative results in both histology and cytology obtained from the segment(s) that were not initially intended to be removed. In contrast to the preoperative estimation, 5 patients were found to have a positive surgical margin and negative cytology, 5 patients demonstrated a negative surgical margin and positive cytology, and 8 patients demonstrated a positive surgical margin and positive cytology. Investigations of the resected specimens revealed that 8 patients (19%) had skip lesions in addition to the main lesion. Logistic regression analysis revealed that patients with a dilated main pancreatic duct, or those with cancerous lesions in the main tumors, were at high risk for positive histology and/or cytology. CONCLUSIONS. Using intraoperative frozen-section histology and pancreatic juice cytology, 18 out of 43 patients in the current study (42%) required additional resection of the pancreas. A necessary and sufficient range of resection should be determined by intraoperative examination.

UR - http://www.scopus.com/inward/record.url?scp=33751577352&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33751577352&partnerID=8YFLogxK

U2 - 10.1002/cncr.22301

DO - 10.1002/cncr.22301

M3 - Article

C2 - 17054109

AN - SCOPUS:33751577352

VL - 107

SP - 2567

EP - 2575

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 11

ER -