Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN).

摘要: Although IPMN are thought to represent a whole-gland disease, segmental resection remains the most frequently performed treatment. We sought determine rates, patterns, and predictors of progression in pancreatic remnant following noninvasive or microinvasive IPMN. A prospectively maintained database was queried identify all patients who underwent (≤ 10 mm invasive component) between 1989 2015. Progression (recurrence) defined as either development cancer, new cystic lesion > 1 cm or ≥ 50% increase diameter residual lesions remnant. Univariate multivariate cox regression models were created progression. total 319 for The median age 68, 53% had branch-duct (BD) IPMN, 6% disease. After follow-up 42 months, 71 (22%) experienced Within this group patients, 11 (16% recurrence) developed cancer after 28 months. Twelve (17%) progression > 5 years initial resection. On analysis, distal location lesion associated with an increased risk (multivariate hazards ratio = 2.43, confidence interval 1.47–4.0, p < 0.001). In study, 22% disease IPMN; 16% these progressions represented These high-risk should undergo long-term radiographic surveillance.