Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Marsoner, K; Haybaeck, J; Csengeri, D; Waha, JE; Schagerl, J; Langeder, R; Mischinger, HJ; Kornprat, P.
Pancreatic resection for intraductal papillary mucinous neoplasm- a thirteen-year single center experience.
BMC Cancer. 2016; 16(1):844-844
Doi: 10.1186/s12885-016-2887-8
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- Führende Autor*innen der Med Uni Graz
- Haybäck Johannes
- Kornprat Peter
- Marsoner Katharina
- Co-Autor*innen der Med Uni Graz
- Csengeri Dora
- Mischinger Hans-Jörg
- Waha James Elvis
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- Abstract:
- The purpose of this study is to review our results for pancreatic resection in patients with intraductal papillary mucinous neoplasm (IPMN) with and without associated carcinoma. A total of 54 patients undergoing pancreatic resection for IPMN in a single university surgical center (Medical University of Graz) were reviewed retrospectively. Their survival rates were compared to those of patients with pancreatic ductal adenocarcinoma. Twenty-four patients exhibit non-invasive IPMN and thirty patients invasive IPMN with associated carcinoma. The mean age is 67 (+/-11) years, 43 % female. Surgical strategies include classical or pylorus-preserving Whipple procedure (n = 30), distal (n = 13) or total pancreatectomy (n = 11), and additional portal venous resection in three patients (n = 3). Median intensive care stay is three days (range 1 - 87), median in hospital stay is 23 days (range 7 - 87). Thirty-day mortality is 3.7 %. Median follow up is 42 months (range 0 - 127). One-, five- and ten-year overall actuarial survival is 87 %; 84 % and 51 % respectively. Median overall survival is 120 months. Patients with non-invasive IPMN have significantly better survival than patients with invasive IPMN and IPMN-associated carcinoma (p < 0.008). In the subgroup of invasive IPMN with associated carcinoma, a positive nodal state, perineural invasion as well as lymphovascular infiltration are associated with poor outcome (p < 0.0001; <0.0001 and =0.001, respectively). Elevated CA 19-9(>37 U/l) as well as elevated lipase (>60 U/l) serum levels are associated with unfavorable outcome (p = 0.009 and 0.018; respectively). Patients operated for pancreatic ductal adenocarcinoma show significantly shorter long-term survival than patients with IPMN associated carcinoma (p = 0.001). Long-term outcome after pancreatic resection for non-invasive IPMN is excellent. Outcome after resection for invasive IPMN with invasive carcinoma is significantly better than for pancreatic ductal adenocarcinoma. In low- and intermediate risk IPMN with no clear indication for immediate surgical resection, a watchful waiting strategy should be evaluated carefully against surgical treatment individually for each patient.
- Find related publications in this database (using NLM MeSH Indexing)
- Adenocarcinoma, Mucinous - diagnosis
- Adenocarcinoma, Mucinous - mortality
- Adenocarcinoma, Mucinous - surgery
- Adenocarcinoma, Papillary - diagnosis
- Adenocarcinoma, Papillary - mortality
- Adenocarcinoma, Papillary - surgery
- Adult -
- Aged -
- Aged, 80 and over -
- Carcinoma, Pancreatic Ductal - diagnosis
- Carcinoma, Pancreatic Ductal - mortality
- Carcinoma, Pancreatic Ductal - surgery
- Female -
- Follow-Up Studies -
- Humans -
- Length of Stay -
- Male -
- Middle Aged -
- Morbidity -
- Multimodal Imaging -
- Neoplasm Staging -
- Pancreatectomy - adverse effects
- Pancreatectomy - methods
- Pancreatic Neoplasms - diagnosis
- Pancreatic Neoplasms - mortality
- Pancreatic Neoplasms - surgery
- Survival Analysis -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Invasive intraductal papillary mucinous neoplasm (IPMN)
- Non-invasive IPMN
- Invasive IPMN
- IPMN associated carcinoma
- Pancreatic resection
- Perioperative outcome
- Long-term survival