Prognosis of cancer with branch duct type IPMN of the pancreas

Table 1 Characteristics of patients with branch duct type IPMN

	Total (n = 145)	Resection (n = 33)	Non-resection (n = 112)
Age (mean ± SD) (yr)	66.3 ± 10.2	63.9 ± 10.5	67.0 ± 10.1
		NS
Male:female	79:66	20:13	59:53
		NS
Median diameter of cystic lesion (mm)	20.1 ± 13.0	23.8 ± 11.5	19 ± 13.3
		P < 0.05
Median diameter of MPD (mm)	2.2 ± 2.3	3.6 ± 3.3	1.7 ± 1.8
		P < 0.01
Median diameter of mural nodule (mm)	1.6 ± 5.3	5.8 ± 9.8	0.3 ± 1.6
		P < 0.01

P: P value (The presence of a statistically significant difference was denoted by P < 0.05). IPMN: Intraductal papillary mucinous neoplasms of the pancreas; SD: Standard deviation; MPD: Main pancreatic duct; NS: Not significant.

Table 2 Comparison of the branch type IPMN in patients with or without intra- or extra-pancreatic cancer

	IPMN with intra- or extra-pancreatic cancer (resection/non-resection)	IPMN without intra- or extra-pancreatic cancer (resection/non-resection)	P value
n	47 (16/31)	98 (19/79)
Age	68.4 (65.0/70.0)	65.4 (63.2/66.4)	NS
Sex (male:female)	22:25 (7:9/15:16)	57:41 (13:6/44:35)	NS
Median diameter of cystic lesion (mm)	20.8 ± 11.8 (23.3 ± 10.4/19.5 ± 12.4)	19.7 ± 13.6 (23.0 ± 13.3/19.0 ± 13.7)	NS
Median diameter of MPD (mm)	2.2 ± 2.4 (3.5 ± 3.6/1.6 ± 1.2)	2.1 ± 2.3 (3.6 ± 2.9/1.7 ± 1.9)	NS
Median diameter of mural nodule (mm)	2.1 ± 5.7 (5.3 ± 8.7/0.5 ± 1.9)	1.3 ± 5.1 (5.6 ± 10.5/0.3 ± 1.5)	NS

Table 3 Incidence of, and detection time, for intra- or extra-pancreatic cancer in patients with IPMN (resected cases)

Neoplasm	Consciousness detection prior IPMN	Simultaneous with detection of carcinoma and IPMN	During follow-up for IPMN	Total
Gastric cancer	7 (1)	3 (3)	3 (0)	13 (4)
Colon cancer	4 (1)	4 (0)	0	8 (1)
Breast cancer	5 (2)	0	2 (0)	7 (2)
Pancreatic cancer	0	5 (4)	0	5 (4)
Lung cancer	3 (2)	1 (1)	1 (0)	5 (3)
Prostate cancer	2 (0)	0	1 (1)	3 (1)
Skin cancer	2 (1)	0	0	2 (1)
Liver cancer	1 (0)	0	0	1 (0)
Bile duct cancer	0	0	1 (0)	1 (0)
Pharyngeal cancer	1 (0)	0	0	1 (0)
Laryngeal cancer	1 (1)	0	0	1 (1)
Thyroid cancer	1 (0)	0	0	1 (0)
Renal cancer	0	1 (1)	0	1 (1)
Bladder cancer	1 (1)	0	0	1 (1)
Malignant lymphoma	1 (0)	0	0	1 (0)
Total	29 (9)	14 (9)	8 (1)	51 (19)

Table 4 Details of clinicopathological findings in fatal cases of IPMN

	Sex	Age (yr)	Region	Change of cystic lesion (mm)	Change of MPD (mm)	Change of mural nodule (mm)	Resection	Histopathological result	Period from diagnosis (operation) to death (mo)	Cause of death
Case 1	Male	89	Head	60→90	10→20	10→30	(-)	Adenocarcinoma (ch+, du+)	37	Cancer of death
Case 2	Male	58	Head	20→64	3→10	0→64	(-)	Adenocarcinoma (ch+, du+)	112	Cancer of death
Case 3	Male	53	Tail	35	1	19	(+)	Invasive ductal carcinoma derived from IPMN (INFα, mpd+)	15 (14)	Cancer of death
Case 4	Female	58	Head	0	1	26.6	(+)	Invasive ductal carcinoma derived from IPMN (INFβ, V2, ne1, du+, rp+)	9 (8)	Cancer of death

Table 5 Summary of the reports of concomitant extra-pancreatic cancers in patients with IPMN

Author (yr)	Number of IPMN patients	Extra-pancreatic cancers with IPMN patients	Age (mean ± SD)	Male:female	Follow-up period (mo)
Zhong (1996)	21	5	NA	NA	NA
Sugiyama (1999)	42	15	NA	NA	NA
Adsay (2002)	28	8	NA	NA	NA
Osanai (2003)	148	35	70.9	31:4	NA
Kamisawa (2005)	79	37	NA	NA	NA
Eguchi (2006)	69	32	NA	NA	NA
Choi (2006)	61	18	64.2 ± 8.4	13:5	65.8 ± 8.5
Yoon (2008)	210	77	65.3 ± 9.0	47:30	24.7
Ishida (2008)	61	151	67.0 ± 7.0	12:3	50.9
Present study	145	422	68.3 ± 9.0	20:26	49.8 ± 42.4
Total	864	2843

¹In those 2 patients who had metachronous double extra-pancreatic malignancies;

²In those 4 patients who had metachronous double extra-pancreatic malignancies;

³In those 6 patients who had metachronous double extra-pancreatic malignancies. NA: Not available.

Table 6 Types of cancers reported concomitant with extra-pancreatic cancers in patients with IPMN

Neoplasm	Zhong (1996)	Sugiyama (1999)	Adsay (2002)	Osanai (2003)	Kamisawa (2005)	Egichi (2006)	Choi (2006)	Yoon (2008)	Ishida (2008)	Present study	Total
Gastric cancer	0	4	0	8	12	4	8	29	6	13	84
Colon cancer	3	5	0	11	7	8	4	16	4	8	66
Lung cancer	0	1	1	5	4	5	0	3	1	5	25
Bile duct cancer	0	1	0	4	1	NS	2	8	1	1	18
Prostate cancer	0	1	1	2	1	2	0	1	0	3	11
Renal cancer	0	1	1	2	0	2	0	3	1	1	11
Breast cancer	0	1	0	0	2	NS	0	0	0	7	10
Esophageal cancer	2	0	0	2	4	NS	0	0	1	0	9
Malignant lymphoma	0	0	0	0	1	NS	2	4	1	1	9
Bladder cancer	0	1	1	0	0	2	1	1	0	1	7
Liver cancer	0	0	0	1	2	NS	0	1	1	1	6
Thyroid cancer	0	0	0	0	0	NS	1	3	0	1	5
Ampullary cancer	0	0	1	0	0	NS	0	3	1	0	5
Skin cancer	0	0	1	0	0	NS	0	1	0	2	4
Uterine cancer	0	0	0	0	1	NS	0	2	0	0	3
Laryngeal cancer	0	0	0	0	1	NS	0	0	0	1	2
Pharyngeal cancer	0	0	0	0	1	NS	0	0	0	1	2
Ovarian cancer	0	0	0	0	0	NS	0	1	0	0	1
Duodenal cancer	0	0	0	0	0	NS	0	1	0	0	1
Other cancer or unknown	0	0	2	0	0	9	0	0	0	0	11
Total	5	15	8	35	37	32	18	77	17	46	290