• Ann. Surg. Oncol. · Feb 2005

    Multicenter Study

    Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery?

    • Jin-Young Jang, Sun-Whe Kim, Young Joon Ahn, Yoo-Seok Yoon, Min Gew Choi, Kuhn Uk Lee, Joon Koo Han, Woo Ho Kim, Young Joo Lee, Song Chul Kim, Duck Jong Han, Yong Il Kim, Seong Ho Choi, Baik Hwan Cho, Hee Chul Yu, Dong Sup Yoon, Woo Jung Lee, Kyung Bum Lee, Young Chul Kim, Kwang Soo Lee, Myung-Wook Kim, Hong Jin Kim, Hyun Jong Kim, and Yong-Hyun Park.
    • Department of Surgery, Seoul National University Hospital, 28 Yongon-dong, Changno-gu, 110-744 Seoul, Korea.
    • Ann. Surg. Oncol. 2005 Feb 1; 12 (2): 124-32.

    BackgroundDespite recently increasing numbers of reports on intraductal papillary mucinous tumors (IPMTs), difficulties still remain in terms of diagnosis, treatment, and prognosis. The purpose of this multicenter study was to evaluate the clinicopathologic features of IPMT in Korea and to suggest predictive criteria for malignancy in IPMT.MethodsWe retrospectively reviewed the clinicopathologic data of 208 patients who underwent operations for IPMT between 1993 and 2002 at 28 institutes in Korea.ResultsOf the 208 patients (mean age, 61 years), 147 were men and 61 were women. A total of 124 patients underwent pancreatoduodenectomy, 42 underwent distal pancreatectomy, 17 underwent total pancreatectomy, and 25 underwent limited pancreatic resection. There were 128 benign cases (adenoma, n = 62; borderline, n = 66) and 80 malignant cases (noninvasive, n = 29; invasive, n = 51). A significant difference in 5-year survival was observed between the benign and malignant groups (92.6% vs. 65.3%; P = .006). Of the six factors (age, location, duct dilatation, mural nodule, main duct type, and tumor size) that showed statistical differences by univariate analysis between the benign and malignant groups, three were significant by multivariate analysis--namely, mural nodule (P = .009), tumor size (P = .023), and a dilated duct size (P = .010).ConclusionsA significant proportion of IPMTs are malignant, although the overall prognosis of IPMT is superior to that of ordinary pancreatic cancer. Radical surgery is recommended for IPMT with the predictors of malignancy: mural nodule, tumor size (> or =30 mm), and dilated duct size (> or =12 mm).

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