Should all branch-duct intraductal papillary mucinous neoplasms be resected? Journal Article

Authors: Plichta, J. K.; Ban, K.; Fridirici, Z.; Godambe, A. S.; Yong, S.; Pappas, S.; Abood, G. J.; Aranha, G. V.
Article Title: Should all branch-duct intraductal papillary mucinous neoplasms be resected?
Abstract: BACKGROUND: The relationship between branch-duct intraductal papillary mucinous neoplasms (IPMNs) and malignancy remains controversial and difficult to assess. METHODS: Between January 1, 1999 and January 1, 2013, we identified 84 patients with IPMN who underwent resection. RESULTS: Preoperatively, 55 patients underwent endoscopic ultrasounds and 58 underwent biopsy. Only 7 lesions were specified preoperatively as branch-duct, which inconsistently correlated with the surgical specimen. Of the 82 patients where the duct was specified, there were 33 malignant lesions. There was no correlation between branch-duct origin and invasive carcinoma. Malignant tumor size did not significantly differ by the duct of origin. Of the 28 patients with invasive carcinoma, branch-duct lesions were significantly associated with the presence of positive lymph nodes, perineural invasion, and lymphovascular invasion. CONCLUSIONS: Our study supports the resection criteria for branch-duct IPMN based on size and symptoms. However, it also questions the reliability of our preoperative testing to rule out malignant branch-duct IPMN lesions.
Journal Title: American Journal of Surgery
Volume: 209
Issue: 3
ISSN: 1879-1883; 0002-9610
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2015
Start Page: 478
End Page: 482
Language: eng
Notes: CI: Copyright (c) 2015; JID: 0370473; OTO: NOTNLM; 2014/07/22 [received]; 2014/10/28 [revised]; 2014/10/31 [accepted]; 2014/12/17 [aheadofprint]; ppublish