Predictive factors for the metachronous development of high-risk lesions in the remnant pancreas after partial pancreatectomy for intraductal papillary mucinous Neoplasm

Yoshihiro Miyasaka, Ohtsuka Takao, Koji Tamura, Yasuhisa Mori, Koji Shindo, Daisuke Yamada, Shunichi Takahata, Kousei Ishigami, Tetsuhide Ito, Shoji Tokunaga, Yoshinao Oda, Kazuhiro Mizumoto, Masafumi Nakamura, Masao Tanaka

研究成果: ジャーナルへの寄稿記事

25 引用 (Scopus)

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Objective: To identify factors predicting the development of high-risk lesions in the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). Background: IPMN has unique features, including multifocality, adenomacarcinoma sequence, and the development of distinct pancreatic ductal adenocarcinoma (PDAC) in the same pancreas. Careful attention should, therefore, be paid to the metachronous occurrence of high-risk lesions, including high-grade dysplasia or invasive carcinoma (HGD/INV) of IPMN and concomitant PDAC in the remnant pancreas after partial pancreatectomy for IPMN. Methods: Clinicopathologic and surveillance data for 195 patients who underwent partial pancreatectomy for IPMN were reviewed retrospectively. Results: Thirteen patients exhibited metachronous development of high-risk lesions including 6 HGD/INV and 7 concomitant PDACs in the remnant pancreas. The 5-and 10-year cumulative incidences of metachronous high-risk lesions in the remnant pancreas were 7.8% and 11.8%, respectively. Twelve of 13 patients had high-risk lesions at the time of initial surgery, and 10 of the 13 IPMNs were located in the distal pancreas. The IPMN subtypes initially resected were gastric in 6 patients, intestinal in 5, and pancreatobililary in the remaining 2. Univariate and multiple regression analyses identified pathologic results of HGD/INV and IPMN located in the distal pancreas as independent predictive factors for metachronous HGD/INVof IPMN, and the pancreatobiliary subtype of IPMN and presence of concomitant PDAC for metachronous PDAC. Conclusions: Patients undergoing partial pancreatectomy for IPMN are at high risk of developing lesions requiring surgery in the remnant pancreas, and close, long-term surveillance should be considered in these patients.

元の言語英語
ページ(範囲)1180-1187
ページ数8
ジャーナルAnnals of Surgery
263
発行部数6
DOI
出版物ステータス出版済み - 1 1 2016

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Pancreatectomy
Pancreas
Neoplasms
Adenocarcinoma
Carcinoma, Intraductal, Noninfiltrating
Papillary Carcinoma
Pancreatic Neoplasms
Stomach
Regression Analysis
Carcinoma
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

これを引用

Predictive factors for the metachronous development of high-risk lesions in the remnant pancreas after partial pancreatectomy for intraductal papillary mucinous Neoplasm. / Miyasaka, Yoshihiro; Takao, Ohtsuka; Tamura, Koji; Mori, Yasuhisa; Shindo, Koji; Yamada, Daisuke; Takahata, Shunichi; Ishigami, Kousei; Ito, Tetsuhide; Tokunaga, Shoji; Oda, Yoshinao; Mizumoto, Kazuhiro; Nakamura, Masafumi; Tanaka, Masao.

:: Annals of Surgery, 巻 263, 番号 6, 01.01.2016, p. 1180-1187.

研究成果: ジャーナルへの寄稿記事

Miyasaka, Yoshihiro ; Takao, Ohtsuka ; Tamura, Koji ; Mori, Yasuhisa ; Shindo, Koji ; Yamada, Daisuke ; Takahata, Shunichi ; Ishigami, Kousei ; Ito, Tetsuhide ; Tokunaga, Shoji ; Oda, Yoshinao ; Mizumoto, Kazuhiro ; Nakamura, Masafumi ; Tanaka, Masao. / Predictive factors for the metachronous development of high-risk lesions in the remnant pancreas after partial pancreatectomy for intraductal papillary mucinous Neoplasm. :: Annals of Surgery. 2016 ; 巻 263, 番号 6. pp. 1180-1187.
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title = "Predictive factors for the metachronous development of high-risk lesions in the remnant pancreas after partial pancreatectomy for intraductal papillary mucinous Neoplasm",
abstract = "Objective: To identify factors predicting the development of high-risk lesions in the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). Background: IPMN has unique features, including multifocality, adenomacarcinoma sequence, and the development of distinct pancreatic ductal adenocarcinoma (PDAC) in the same pancreas. Careful attention should, therefore, be paid to the metachronous occurrence of high-risk lesions, including high-grade dysplasia or invasive carcinoma (HGD/INV) of IPMN and concomitant PDAC in the remnant pancreas after partial pancreatectomy for IPMN. Methods: Clinicopathologic and surveillance data for 195 patients who underwent partial pancreatectomy for IPMN were reviewed retrospectively. Results: Thirteen patients exhibited metachronous development of high-risk lesions including 6 HGD/INV and 7 concomitant PDACs in the remnant pancreas. The 5-and 10-year cumulative incidences of metachronous high-risk lesions in the remnant pancreas were 7.8{\%} and 11.8{\%}, respectively. Twelve of 13 patients had high-risk lesions at the time of initial surgery, and 10 of the 13 IPMNs were located in the distal pancreas. The IPMN subtypes initially resected were gastric in 6 patients, intestinal in 5, and pancreatobililary in the remaining 2. Univariate and multiple regression analyses identified pathologic results of HGD/INV and IPMN located in the distal pancreas as independent predictive factors for metachronous HGD/INVof IPMN, and the pancreatobiliary subtype of IPMN and presence of concomitant PDAC for metachronous PDAC. Conclusions: Patients undergoing partial pancreatectomy for IPMN are at high risk of developing lesions requiring surgery in the remnant pancreas, and close, long-term surveillance should be considered in these patients.",
author = "Yoshihiro Miyasaka and Ohtsuka Takao and Koji Tamura and Yasuhisa Mori and Koji Shindo and Daisuke Yamada and Shunichi Takahata and Kousei Ishigami and Tetsuhide Ito and Shoji Tokunaga and Yoshinao Oda and Kazuhiro Mizumoto and Masafumi Nakamura and Masao Tanaka",
year = "2016",
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language = "English",
volume = "263",
pages = "1180--1187",
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TY - JOUR

T1 - Predictive factors for the metachronous development of high-risk lesions in the remnant pancreas after partial pancreatectomy for intraductal papillary mucinous Neoplasm

AU - Miyasaka, Yoshihiro

AU - Takao, Ohtsuka

AU - Tamura, Koji

AU - Mori, Yasuhisa

AU - Shindo, Koji

AU - Yamada, Daisuke

AU - Takahata, Shunichi

AU - Ishigami, Kousei

AU - Ito, Tetsuhide

AU - Tokunaga, Shoji

AU - Oda, Yoshinao

AU - Mizumoto, Kazuhiro

AU - Nakamura, Masafumi

AU - Tanaka, Masao

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective: To identify factors predicting the development of high-risk lesions in the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). Background: IPMN has unique features, including multifocality, adenomacarcinoma sequence, and the development of distinct pancreatic ductal adenocarcinoma (PDAC) in the same pancreas. Careful attention should, therefore, be paid to the metachronous occurrence of high-risk lesions, including high-grade dysplasia or invasive carcinoma (HGD/INV) of IPMN and concomitant PDAC in the remnant pancreas after partial pancreatectomy for IPMN. Methods: Clinicopathologic and surveillance data for 195 patients who underwent partial pancreatectomy for IPMN were reviewed retrospectively. Results: Thirteen patients exhibited metachronous development of high-risk lesions including 6 HGD/INV and 7 concomitant PDACs in the remnant pancreas. The 5-and 10-year cumulative incidences of metachronous high-risk lesions in the remnant pancreas were 7.8% and 11.8%, respectively. Twelve of 13 patients had high-risk lesions at the time of initial surgery, and 10 of the 13 IPMNs were located in the distal pancreas. The IPMN subtypes initially resected were gastric in 6 patients, intestinal in 5, and pancreatobililary in the remaining 2. Univariate and multiple regression analyses identified pathologic results of HGD/INV and IPMN located in the distal pancreas as independent predictive factors for metachronous HGD/INVof IPMN, and the pancreatobiliary subtype of IPMN and presence of concomitant PDAC for metachronous PDAC. Conclusions: Patients undergoing partial pancreatectomy for IPMN are at high risk of developing lesions requiring surgery in the remnant pancreas, and close, long-term surveillance should be considered in these patients.

AB - Objective: To identify factors predicting the development of high-risk lesions in the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). Background: IPMN has unique features, including multifocality, adenomacarcinoma sequence, and the development of distinct pancreatic ductal adenocarcinoma (PDAC) in the same pancreas. Careful attention should, therefore, be paid to the metachronous occurrence of high-risk lesions, including high-grade dysplasia or invasive carcinoma (HGD/INV) of IPMN and concomitant PDAC in the remnant pancreas after partial pancreatectomy for IPMN. Methods: Clinicopathologic and surveillance data for 195 patients who underwent partial pancreatectomy for IPMN were reviewed retrospectively. Results: Thirteen patients exhibited metachronous development of high-risk lesions including 6 HGD/INV and 7 concomitant PDACs in the remnant pancreas. The 5-and 10-year cumulative incidences of metachronous high-risk lesions in the remnant pancreas were 7.8% and 11.8%, respectively. Twelve of 13 patients had high-risk lesions at the time of initial surgery, and 10 of the 13 IPMNs were located in the distal pancreas. The IPMN subtypes initially resected were gastric in 6 patients, intestinal in 5, and pancreatobililary in the remaining 2. Univariate and multiple regression analyses identified pathologic results of HGD/INV and IPMN located in the distal pancreas as independent predictive factors for metachronous HGD/INVof IPMN, and the pancreatobiliary subtype of IPMN and presence of concomitant PDAC for metachronous PDAC. Conclusions: Patients undergoing partial pancreatectomy for IPMN are at high risk of developing lesions requiring surgery in the remnant pancreas, and close, long-term surveillance should be considered in these patients.

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