Korean J Hepatobiliary Pancreat Surg.
2003 Jun;7(1):1-11.
Analysis of Clinical Features and Factors Predictive of Malignancy in Intraductal Papillary Mucinous Tumor of the Pancreas: Multi-center Analysis in Korea
- Affiliations
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- 1Department of Surgery, Seoul National University, Korea. sunkim@snu.ac.kr
- 2Department of Surgery, Ulsan University, Korea.
- 3Department of Surgery, Sungkyunkwan University, Korea.
- 4Department of Surgery, Chonbuk National University, Korea.
- 5Department of Surgery, Yonsei University, Korea.
- 6Department of Surgery, Korea University, Korea.
- 7Department of Surgery, Hanyang University, Korea.
- 8Department of Surgery, Kyungpook National University, Korea.
- 9Department of Surgery, Gyengsang National University, Korea.
- 10Department of Surgery, Keimyung University, Korea.
- 11Department of Surgery, National Medical Center, Korea.
- 12Department of Surgery, Catholic University of Daegu, Korea.
- 13Department of Surgery, Daegu Fatima Hospital, Korea.
- 14Department of Surgery, Dong-A University, Korea.
- 15Department of Surgery, Pusan National University, Korea.
- 16Department of Surgery, Soonchunhyang University, Korea.
- 17Department of Surgery, Inje University, Korea.
- 18Department of Surgery, Ajou University, Korea.
- 19Department of Surgery, Yeungnam University, Korea.
- 20Department of Surgery, Wonkwang University, Korea.
- 21Department of Surgery, Korea Cancer Center Hospital, Korea.
- 22Department of Surgery, Ewha Women University, Korea.
- 23Department of Surgery, Inha University, Korea.
- 24Department of Surgery, National Health Insurance Corporation Ilsan Hospital, Korea.
- 25Department of Surgery, Chonnam National University, Korea.
- 26Department of Surgery, Chungbuk National University, Korea.
- 27Department of Surgery, Cheonju St. Mary's Hospital, Korea.
- 28Department of Surgery, Hallym University, Korea.
Abstract
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BACKGROUND/AIMS: Despite of increasing numbers of reports on intraductal papillary mucinous tumor (IPMT), there is still difficulty in its' diagnosis, treatment and prediction of prognosis. The purpose of this multicenter study was to evaluate the clinico-pathological features of IPMT in Korea and suggest the prediction criteria of malignancy in IPMT.
METHODS
We retrospectively reviewed the clinico-pathological data of 208 patients who underwent operations with IPMT between 1993 and 2002 at 28 institutes in Korea.
RESULTS
Of the 208 patients with a mean age of 60.5+/-9.7 years, 147 were men and 61 were women. 124 patients underwent pancreatoduodenectomy, 42 distal pancreatectomy, 17 total pancreatectomy, 25 limited pancreas resection. Benign cases were 128 (adenoma (n=62), borderline (n=66)) and malignant cases were 80 (non-invasive (n=29), invasive (n=51)). A significant difference in 5-year survival was observed between benign and malignant group (92.6% vs. 65.3%; p=0.006). Of the 6 factors (age, location, duct dilatation, tumor appearance, main duct type, and tumor size) that showed the statistical difference in univariate analysis between benign and malignant group, we found three significant factors (tumor appearance (p=0.009), tumor size (p=0.023), and dilated duct size (p=0.010)) by multivariate analysis.
CONCLUSION
Although overall prognosis of IPMT is superior to ordinary pancreatic cancer, more curative surgery is recommended in malignant IPMT. Tumor appearance (papillary), tumor size (> or =30 mm) and dilated duct size (> or = 12 mm) can be used as preoperative indicators of malig-nancy in IPMT.
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