Outcomes of intraductal papillary mucinous neoplasm with "Sendai-positive" criteria for resection undergoing non-operative management

Dig Liver Dis. 2013 Jul;45(7):584-8. doi: 10.1016/j.dld.2013.01.016. Epub 2013 Feb 27.


Background: There are few data on the outcome of patients with intraductal papillary mucinous neoplasms of the pancreas meeting criteria for resection (Sendai-positive), and not operated.

Aim: To evaluate outcome of patients with a resectable, Sendai-positive intraductal papillary mucinous neoplasm, and not operated.

Methods: Multicentre, retrospective analysis of prospectively enrolled patients, with resectable Sendai-positive, not-operated intraductal papillary mucinous neoplasm. Overall-survival and disease-specific survival were the primary end-point, and progression-free survival secondary.

Results: Thirty-five patients (60% male, median age 77) enrolled: 40% main-duct, 60% branch-duct intraductal papillary mucinous neoplasms. In 19 patients surgery was ruled out due to comorbidities, in 7 because aged > 80, 9 refused surgery. Twelve (34.3%) patients died after a mean of 32.5 months, 8 due to disease progression, 4 due to comorbidities. The median overall, disease-specific and progression-free survival were 52, 55, and 44 months respectively. Main duct involvement and age at diagnosis were associated with worse overall and progression-free survival, only main duct involvement with worse disease-specific survival (52 months main duct vs. 64 branch duct; P = 0.04).

Conclusion: These results suggest that in elderly and comorbid patients with Sendai-positive intraductal papillary mucinous neoplasms, especially of the branch duct, a conservative approach could be reasonable, as associated with a relatively good outcome, and should be carefully discussed with the patients.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adenocarcinoma, Mucinous / mortality*
  • Adenocarcinoma, Mucinous / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases
  • Carcinoma, Pancreatic Ductal / mortality*
  • Carcinoma, Pancreatic Ductal / therapy
  • Carcinoma, Papillary / mortality*
  • Carcinoma, Papillary / therapy
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / therapy
  • Retrospective Studies