Topic Highlight
Copyright ©2010 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Oct 27, 2010; 2(10): 359-362
Published online Oct 27, 2010. doi: 10.4240/wjgs.v2.i10.359
Prognosis of invasive intraductal papillary mucinous neoplasms of the pancreas
Adam C Yopp, Peter J Allen
Adam C Yopp, Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
Peter J Allen, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States
Author contributions: Yopp AC and Allen PJ wrote this paper.
Correspondence to: Dr. Peter J Allen, MD, Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 1275 York Avenue, New York, NY 10065, United States. allenp@mskcc.org
Telephone: +1-212-6395132 Fax: +1-212-7172645
Received: May 18, 2010
Revised: September 20, 2010
Accepted: September 27, 2010
Published online: October 27, 2010
Abstract

Intraductal papillary mucinous neoplasms (IPMN) are mucin producing cystic neoplasms of the pancreas histologically classified as having non-invasive and invasive components. The five-year survival rates for non-invasive and associated invasive carcinoma are 90% and 40%, respectively in resected IPMN lesions. Invasive carcinoma within IPMN lesions can be further classified by histological subtype into colloid carcinoma and tubular carcinoma. Estimated five-year survival rates following resection of colloid carcinoma range from 57%-83% and estimated five-year survival following resection of tubular carcinoma range from 24%-55%. The difference in survival outcome between invasive colloid and tubular IPMN appears to be a function of disease biology, as patients with the tubular subtype tend to have larger tumors with a propensity for metastasis to regional lymph nodes. When matched to resected conventional pancreatic adenocarcinoma lesions by the Memorial Sloan Kettering Cancer Center pancreatic adenocarcinoma nomogram, the colloid carcinoma histological subtype has an improved estimated five-year survival outcome compared to conventional pancreatic adenocarcinoma, 87% and 23% (P = 0.0001), respectively. Resected lesions with the tubular carcinoma subtype overall have a similar five-year survival outcome compared to conventional pancreatic adenocarcinoma. However, when these groups were stratified by regional lymph node status patients with negative regional lymph nodes and the tubular subtype experienced significantly better survival than patients with a similar nodal status and ductal adenocarcinoma with estimated five-year survival rates of 73% and 27% (P = 0.01), respectively.

Keywords: Intraductal papillary mucinous neoplasms; Pancreatic adenocarcinoma; Prognosis