Surveillance of patients with intraductal papillary mucinous neoplasm with and without pancreatectomy with special reference to the incidence of concomitant pancreatic ductal adenocarcinoma
Surveillance of patients with intraductal papillary mucinous neoplasm with and without pancreatectomy with special reference to the incidence of concomitant pancreatic ductal adenocarcinoma
复制标题
DOI：
10.1016/j.surg.2017.09.040
复制
发表时间：
2018-02-01
期刊：
影响因子：
3.8
通讯作者：
Nakamura, Masafumi
中科院分区：
文献类型：
--
作者：
Date, Kenjiro;Ohtsuka, Takao;Nakamura, Masafumi
背景导管内乳头状黏液性肿瘤的存在对于发现伴发的胰腺导管腺癌很重要。本研究的目的是阐明胰腺导管内乳头状黏液性肿瘤患者行胰腺切除术和未行胰腺切除术时并发胰腺导管腺癌的发生率和发生时间。我们回顾性分析了22例因胰腺导管腺癌伴导管内乳头状黏液性肿瘤行胰腺切除术的患者（胰腺导管腺癌切除组）、180例因导管内乳头状黏液性肿瘤行胰腺切除术的患者（导管内乳头状黏液性肿瘤切除组）和263例导管内乳头状黏液性肿瘤未经治疗的患者（非切除组）的监测数据。采用Kaplan-Meier方法研究了在对因导管内乳头状黏液性肿瘤行胰腺部分切除术和未行胰腺部分切除术的患者进行监测期间并发胰腺导管腺癌的发生率和发生时间。在40个月（范围6-262个月）的中位监测期内，胰腺导管腺癌切除组中有5例患者，导管内乳头状粘液性肿瘤切除组中有6例患者，未切除组中有8例患者并发胰腺导管腺癌。胰腺导管腺癌切除术组中继发性胰腺导管腺癌的估计5年（17%）和10年（56%）累积发生率显著高于其他两组（P = 5年）。由于存在发生伴随胰腺导管腺癌的可能性，对导管内乳头状粘液性肿瘤患者进行监测是必要且重要的。初次手术时有胰腺导管腺癌切除史的患者发生继发性胰腺导管腺癌的风险相当高。(C)2017爱思唯尔公司All rights reserved.
Background. The presence of an intraductal papillary mucinous neoplasm is important in the detection of concomitant pancreatic ductal adenocarcinoma. The aim of this study was to elucidate the incidence and timing of development of concomitant pancreatic ductal adenocarcinoma in patients with and without pancreatectomy for intraductal papillary mucinous neoplasm.Methods. We reviewed retrospectively the surveillance data for 22 patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm (pancreatic ductal adenocarcinoma-resection group), 180 who underwent pancreatectomy for intraductal papillary mucinous neoplasm (intraductal papillary mucinous neoplasm-resection group), and 263 whose intraductal papillary mucinous neoplasms were left untreated (nonresection group). The incidence and timing of the development of a concomitant pancreatic ductal adenocarcinoma during the surveillance of patients with and without partial pancreatectomy for intraductal papillary mucinous neoplasm were investigated using the Kaplan-Meier method.Results. During a median surveillance period of 40 months (range 6-262 months), 5 patients in the pancreatic ductal adenocarcinoma-resection group, 6 in the intraductal papillary mucinous neoplasm resection group, and 8 in the nonresection group developed concomitant pancreatic ductal adenocarcinoma. The estimated 5-year (17%) and 10-year (56%) cumulative incidences of secondary pancreatic ductal adenocarcinoma in the pancreatic ductal adenocarcinoma-resection group were significantly greater than those in the other two groups (P = 5-year) surveillance in patients with intraductal papillary mucinous neoplasm is necessary and important because of the potential for development of concomitant pancreatic ductal adenocarcinoma. Those with a history of resection of concomitant pancreatic ductal adenocarcinoma at the time of the initial operation are at quite high risk for the development of secondary pancreatic ductal adenocarcinoma. (C) 2017 Elsevier Inc. All rights reserved.