Potential predictors of disease progression for main-duct intraductal papillary mucinous neoplasms of the pancreas
Version of Record online: 22 OCT 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 11, pages 1782–1786, November 2013
How to Cite
Ogura, T., Masuda, D., Kurisu, Y., Edogawa, S., Imoto, A., Hayashi, M., Uchiyama, K. and Higuchi, K. (2013), Potential predictors of disease progression for main-duct intraductal papillary mucinous neoplasms of the pancreas. Journal of Gastroenterology and Hepatology, 28: 1782–1786. doi: 10.1111/jgh.12301
- Issue online: 22 OCT 2013
- Version of Record online: 22 OCT 2013
- Accepted manuscript online: 25 JUN 2013 08:05PM EST
- Manuscript Accepted: 10 JUN 2013
Background and Aim
The evidence for main pancreatic duct intraductal papillary mucinous neoplasms (MPD-IPMN) malignancy is based predominantly on investigation of resected cases, and the natural history is still unclear. The aim of the present study is to investigate the natural history of MPD-IPMN and examine potential predictors of disease progression in MPD-IPMN patients who conformed to “high-risk stigmata” criteria.
This study included consecutive 20 follow-up patients and 19 surgical patients with “high-risk stigmata” MPD-IPMN, in whom the diameter of the MPD was > 10 mm, branch duct was < 5 mm, and who underwent clinical follow up for ≥ 2 years.
Among surgical patients, mural nodules and MPD diameter of invasive patients were significantly different compared with non-invasive patients. On the other hand, among follow-up patients, univariate analysis revealed the following potential predictors for disease progression: diameter of MPD ≥ 15 mm (hazard ratio [HR], 20.9; 95% confidence interval [CI], 2.59–173.4; P < 0.01); and diffuse lesions of MPD-IPMN (HR, 4.46; 95% CI, 1.10–18.0; P = 0.04). On the other hand, multivariate analysis identified only diameter of MPD ≥ 15 mm (HR, 19.2; 95%CI, 1.87–198.5; P = 0.01) as a potential predictor of disease progression.
If MPD-IPMN patients have other severe complications or reasons for not undergoing surgical treatment, MPD diameter < 15 mm, negative cytology, and no mural nodules, conservative clinical follow up for several years may be an option.