Outcomes of nonresected main-duct intraductal papillary mucinous neoplasms of the pancreas

作     者：Mathieu Daudé Fabrice Muscari Camille Buscail Nicolas Carrère Philippe Otal Janick Selves Louis Buscail Barbara Bournet 

作者机构：Department of GastroenterologyCHU Toulouse RangueilUniversity of Toulouse31059 ToulouseFrance Department of Digestive SurgeryCHU Toulouse Rangueil and PurpanUniversity of Toulouse31059 ToulouseFrance Department of Public Health and EpidemiologyCHU Rennes PontchaillouUniversity of Rennes35033 RennesFrance Department of RadiologyCHU Toulouse RangueilUniversity of Toulouse31059 ToulouseFrance Department of PathologyCHU Toulouse PurpanUniversity of Toulouse31300 ToulouseFrance 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第9期

页      面：2658-2667页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Main-duct intraductal papillary mucinous neoplasms 

摘      要：AIM:To compare characteristics and outcomes of resected and nonresected main-duct and mixed intraductal papillary mucinous neoplasms of the pancreas(IPMN).METHODS:Over a 14-year period,50 patients who did not undergo surgery for resectable main-duct or mixed IPMN,for reasons of precluding comorbidities,age and/or refusal,were compared with 74 patients who underwent resection to assess differences in rates of survival,recurrence/occurrence of malignancy,and prognostic *** study participants had dilatation of the main pancreatic duct by ≥ 5 mm,with or without dilatation of the branch *** of the nonsurgical patients showed evidence of mucus upon perendoscopic retrograde cholangiopancreatography or endoscopic ultrasound and/or after fine needle *** the surgical patients,pathologic analysis of resected specimens confirmed a diagnosis of IPMN with involvement of the main pancreatic duct or of both branch ducts as well as the main pancreatic *** and biologic follow-ups were conducted for all patients at least annually,through hospitalization or consultation every six months during the first year of follow-up,together with abdominal imaging analysis(magnetic resonance cholangiopancreatography or computed tomography) and,if necessary,endoscopic ultrasound with or without fine needle ***:The overall five-year survival rate of patients who underwent resection was significantly greater than that for the nonsurgical patients(74% vs 58%; P =0.019).The parameters of age( 10 mm,branch ductdiameter 30 mm,or presence of extra pancreatic cancers did not significantly influence the *** the nonsurgical patients,pancreatic malignancy occurred in 36% of cases within a mean time of 33 mo(median:29 mo; range:8-141 mo).Comparison of the nonsurgical patients who experienced disease progression