Minimally invasive intraductal papillary-mucinous carcinoma of the pancreas: Clinicopathologic study of 104 intraductal papillary-mucinous neoplasms

Satoshi Nara, Kazuaki Shimada, Tomoo Kosuge, Yae Kanai, Nobuyoshi Hiraoka

Research output: Contribution to journalArticlepeer-review

70 Citations (Scopus)

Abstract

Invasive intraductal papillary-mucinous carcinoma (I-IPMC) is a heterogeneous entity with various postoperative outcomes. The aim of this study is to characterize early-stage I-IPMC with nonaggressive characteristics. One hundred and four patients with intraductal papillary-mucinous neoplasm (IPMN) were clinicopathologically investigated. The lesions were classified into 53 noninvasive IPMNs (adenoma, borderline, and noninvasive IPMC) and 51 I-IPMCs on the basis of the WHO classification. I-IPMCs were divided further into 26 minimally invasive IPMCs (MI-IPMCs) and 25 invasive carcinomas originating in IPMC (IC-IPMCs) by new diagnostic criteria proposed in this study. We examined invasiveness of I-IPMC on 4 patterns, and defined simple and practical diagnostic criteria of minimal invasion for each invasive pattern. The disease-specific survival rates after 3, 5, and 10 years were 100%, 100%, and 100% for both noninvasive IPMN and MI-IPMC, and 51%, 38%, and 0% for IC-IPMC. The overall and disease-specific survival rates for MI-IPMC were both significantly better than those for IC-IPMC (P<0.001), but there was no significant difference between noninvasive IPMN and MI-IPMC. Multivariate analysis showed that the factors indicative of poor prognosis were a diagnosis of I-IPMC classified as IC-IPMC and a high level of serum carbohydrate antigen 19-9. The prognosis of IC-IPMC was not significantly different from that of pancreatic ductal carcinoma in each of the corresponding tumor-node-metastasis stages. These findings suggest that a category of MI-IPMC provides more accurate and useful information of the stage and the aggressiveness of I-IPMC.

Original languageEnglish
Pages (from-to)243-255
Number of pages13
JournalAmerican Journal of Surgical Pathology
Volume32
Issue number2
DOIs
Publication statusPublished - 2008 Feb 1
Externally publishedYes

Keywords

  • Clinicopathologic analysis
  • Intraductal papillary-mucinous neoplasms of the pancreas
  • Invasive pattern
  • Minimal invasion
  • Prognosis

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Minimally invasive intraductal papillary-mucinous carcinoma of the pancreas: Clinicopathologic study of 104 intraductal papillary-mucinous neoplasms'. Together they form a unique fingerprint.

Cite this