Risk factors associated with the postoperative recurrence of intraductal papillary mucinous neoplasms of the pancreas

Pancreas. 2011 Jan;40(1):46-51. doi: 10.1097/MPA.0b013e3181f66b74.

Abstract

Objectives: The risk factors correlated with the post-operative recurrence of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are not well established. The aim was to determine the risk factors of recurrence.

Methods: We reviewed retrospectively the differences of clinicopathologic features between the recurrence and nonrecurrence groups of patients with IPMN who underwent surgical resection and analyzed the recurrence-related factors.

Results: A total of 103 patients were confirmed to have IPMNs. The mean postoperative follow-up was 3.2 years, and the recurrence rate was 12.6%. Recurrent cases (n=13) had the following pathologic grades: adenoma, 1; and invasive carcinoma, 12. The mean postoperative survival was 17.0 months in the recurrence group and 41.4 months in the nonrecurrence group (P<0.001). The independent risk factors of recurrence were invasive carcinoma (P=0.017, hazard ratio=71.79; 95% confidence interval (CI)=2.13-2417.05), elevated carbohydrate antigen 19-9 (P=0.007, hazard ratio=37.97, 95% CI=2.66-542.32), and main location in the pancreatic head (P=0.038, hazard ratio=0.16, 95% CI=0.03-0.90).

Conclusions: The risk factors associated with recurrence of IPMNs were invasive pathology, elevated carbohydrate antigen 19-9, and main location in the pancreatic head. A more careful follow-up is needed for such patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Mucinous / etiology*
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / surgery
  • Adult
  • Aged
  • CA-19-9 Antigen / blood
  • Carcinoma, Pancreatic Ductal / etiology*
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / surgery
  • Carcinoma, Papillary / etiology*
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology*
  • Pancreatic Neoplasms / etiology*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Retrospective Studies
  • Risk Factors

Substances

  • CA-19-9 Antigen