| Theme | Intraductal Papillary Mucinous Neoplasm (IPMN) | |
|---|---|---|
| Title | Japanese Multiinstitutional Study of Pancreatic Intraductal Papillary Mucinous Neoplasms | |
| Publish Date | 2009/08 | |
| Author | Yutaka Suzuki | Department of Surgery, Kyorin University School of Medicine |
| Author | Masanori Sugiyama | Department of Surgery, Kyorin University School of Medicine |
| Author | Nobutsugu Abe | Department of Surgery, Kyorin University School of Medicine |
| Author | Osamu Yanagida | Department of Surgery, Kyorin University School of Medicine |
| Author | Tadahiko Masaki | Department of Surgery, Kyorin University School of Medicine |
| Author | Toshiyuki Mori | Department of Surgery, Kyorin University School of Medicine |
| Author | Yutaka Atomi | Department of Surgery, Kyorin University School of Medicine |
| [ Summary ] | An analysis of management for intraductal papillary mucinous neoplasms (IPMN) was performed in relation to the results of a Japanese multiinstitutional retrospective study of IPMN. The main duct type and the combined type are more likely to be adenocarcinoma than the branch duct type, with significant ration exhibited (65%, 60% vs 29%) . Predictive factors for malignant IPMN were female gender, wide spread pancreatic lesions, main duct diameter 8mm or greater, enlarged papilla orifice or mural nodule size 3mm or greater in main duct type and combined type conditions. Predictive factors include other pancreatic disorders, lesions in the pancreatic head, main duct diameter 5mm or greater, cyst diameter 33mm or larger, enlarged papilla orifice and mural nodule size 2mm or more in the branch duct type. The five-year survival rate for IPMN patients was 98-100% with adenoma or noninvasive carcinoma. Survival rates were 89% for minimally invasive carcinoma, and 57.7% for invasive carcinoma. With main duct and combined type conditions, all cases require surgery because of high rates of adenocarcinoma.In patients with the branch duct type, IPMN requires resection if tumors present one or more features which are symptomatic and predictive factors for malignant IPMN are observed. However, in patients with small tumors located in the pancreatic head, small tumors with other pancreatic disorders or enlarged papilla orifices, follow ups can be performed without surgery. However, periodic check ups for changes in these tumors, employing regular diagnostic imaging, are necessary. Complete checks of other organs are needed because IPMN frequently associated with other malignant neoplasms. | |