Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms

K. Sahora, S. Crippa, G. Zamboni, C. Ferrone, A. L. Warshaw, K. Lillemoe, M. Mino-Kenudson, M. Falconi, C. Fernandez-Del Castillo

Research output: Contribution to journalArticle

Abstract

Background Intraductal papillary mucinous neoplasms (IPMN) have been reported to be associated with concurrent, distinct pancreatic ductal adenocarcinoma (con-PDAC) in about 8% (range, 4-10%) of resected branch duct (BD) lesions. In addition, other pancreatic and ampullary tumors are occasionally diagnosed with IPMN in patients undergoing pancreatic surgery. The objective of this study is to describe the prevalence, clinicopathologic characteristics and prognosis of IPMN with concurrent pancreatic and ampullary neoplasms, especially con-PDAC. Methods The combined databases of pancreatic resections from the Massachusetts General Hospital and the Negrar Hospital, Italy, were analyzed for patients who had been diagnosed with IPMN and concurrent pancreatic or ampullary neoplasms. Results 2762 patients underwent pancreatic surgery from January 2000 to December 2012. Sixteen percent (n = 441) had pathologically confirmed IPMN and 11% of these (n = 50) had a different distinct synchronous pancreatic neoplasm. The majority of these, 62%, were con-PDAC, followed by neuroendocrine neoplasms (10%) and ampullary carcinoma (10%). Less frequently, mucinous (6%) as well as serous cystic neoplasms (6%), adenosquamous carcinoma (4%) and distal bile duct cancer (2%) were diagnosed. Among all patients with synchronous neoplasms, 66% harbored BD-IPMN, 28% combined IPMN and 6% main duct IPMN. Abdominal pain and/or jaundice were the leading symptoms in half of patients. Conclusion IPMN, mainly BD-IPMN, are associated with con-PDAC in about 7% of patients and account for 62% of all concurrent pancreatic/ampullary neoplasms. Other synchronous neoplasms may be found sporadically with IPMN without a suspected association.

Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalEuropean Journal of Surgical Oncology
Volume42
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

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Pancreatic Neoplasms
Neoplasms
Multiple Primary Neoplasms
Adenocarcinoma
Bile Duct Neoplasms
Adenosquamous Carcinoma
Jaundice
General Hospitals
Abdominal Pain
Italy
Databases

Keywords

  • Concurrent neoplasm
  • Intraductal papillary mucinous noeplasm
  • Pancreas
  • Pancreatic cancer

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Sahora, K., Crippa, S., Zamboni, G., Ferrone, C., Warshaw, A. L., Lillemoe, K., ... Fernandez-Del Castillo, C. (2016). Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms. European Journal of Surgical Oncology, 42(2), 197-204. https://doi.org/10.1016/j.ejso.2015.10.014

Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms. / Sahora, K.; Crippa, S.; Zamboni, G.; Ferrone, C.; Warshaw, A. L.; Lillemoe, K.; Mino-Kenudson, M.; Falconi, M.; Fernandez-Del Castillo, C.

In: European Journal of Surgical Oncology, Vol. 42, No. 2, 01.02.2016, p. 197-204.

Research output: Contribution to journalArticle

Sahora, K, Crippa, S, Zamboni, G, Ferrone, C, Warshaw, AL, Lillemoe, K, Mino-Kenudson, M, Falconi, M & Fernandez-Del Castillo, C 2016, 'Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms', European Journal of Surgical Oncology, vol. 42, no. 2, pp. 197-204. https://doi.org/10.1016/j.ejso.2015.10.014
Sahora, K. ; Crippa, S. ; Zamboni, G. ; Ferrone, C. ; Warshaw, A. L. ; Lillemoe, K. ; Mino-Kenudson, M. ; Falconi, M. ; Fernandez-Del Castillo, C. / Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms. In: European Journal of Surgical Oncology. 2016 ; Vol. 42, No. 2. pp. 197-204.
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abstract = "Background Intraductal papillary mucinous neoplasms (IPMN) have been reported to be associated with concurrent, distinct pancreatic ductal adenocarcinoma (con-PDAC) in about 8{\%} (range, 4-10{\%}) of resected branch duct (BD) lesions. In addition, other pancreatic and ampullary tumors are occasionally diagnosed with IPMN in patients undergoing pancreatic surgery. The objective of this study is to describe the prevalence, clinicopathologic characteristics and prognosis of IPMN with concurrent pancreatic and ampullary neoplasms, especially con-PDAC. Methods The combined databases of pancreatic resections from the Massachusetts General Hospital and the Negrar Hospital, Italy, were analyzed for patients who had been diagnosed with IPMN and concurrent pancreatic or ampullary neoplasms. Results 2762 patients underwent pancreatic surgery from January 2000 to December 2012. Sixteen percent (n = 441) had pathologically confirmed IPMN and 11{\%} of these (n = 50) had a different distinct synchronous pancreatic neoplasm. The majority of these, 62{\%}, were con-PDAC, followed by neuroendocrine neoplasms (10{\%}) and ampullary carcinoma (10{\%}). Less frequently, mucinous (6{\%}) as well as serous cystic neoplasms (6{\%}), adenosquamous carcinoma (4{\%}) and distal bile duct cancer (2{\%}) were diagnosed. Among all patients with synchronous neoplasms, 66{\%} harbored BD-IPMN, 28{\%} combined IPMN and 6{\%} main duct IPMN. Abdominal pain and/or jaundice were the leading symptoms in half of patients. Conclusion IPMN, mainly BD-IPMN, are associated with con-PDAC in about 7{\%} of patients and account for 62{\%} of all concurrent pancreatic/ampullary neoplasms. Other synchronous neoplasms may be found sporadically with IPMN without a suspected association.",
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T1 - Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms

AU - Sahora, K.

AU - Crippa, S.

AU - Zamboni, G.

AU - Ferrone, C.

AU - Warshaw, A. L.

AU - Lillemoe, K.

AU - Mino-Kenudson, M.

AU - Falconi, M.

AU - Fernandez-Del Castillo, C.

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N2 - Background Intraductal papillary mucinous neoplasms (IPMN) have been reported to be associated with concurrent, distinct pancreatic ductal adenocarcinoma (con-PDAC) in about 8% (range, 4-10%) of resected branch duct (BD) lesions. In addition, other pancreatic and ampullary tumors are occasionally diagnosed with IPMN in patients undergoing pancreatic surgery. The objective of this study is to describe the prevalence, clinicopathologic characteristics and prognosis of IPMN with concurrent pancreatic and ampullary neoplasms, especially con-PDAC. Methods The combined databases of pancreatic resections from the Massachusetts General Hospital and the Negrar Hospital, Italy, were analyzed for patients who had been diagnosed with IPMN and concurrent pancreatic or ampullary neoplasms. Results 2762 patients underwent pancreatic surgery from January 2000 to December 2012. Sixteen percent (n = 441) had pathologically confirmed IPMN and 11% of these (n = 50) had a different distinct synchronous pancreatic neoplasm. The majority of these, 62%, were con-PDAC, followed by neuroendocrine neoplasms (10%) and ampullary carcinoma (10%). Less frequently, mucinous (6%) as well as serous cystic neoplasms (6%), adenosquamous carcinoma (4%) and distal bile duct cancer (2%) were diagnosed. Among all patients with synchronous neoplasms, 66% harbored BD-IPMN, 28% combined IPMN and 6% main duct IPMN. Abdominal pain and/or jaundice were the leading symptoms in half of patients. Conclusion IPMN, mainly BD-IPMN, are associated with con-PDAC in about 7% of patients and account for 62% of all concurrent pancreatic/ampullary neoplasms. Other synchronous neoplasms may be found sporadically with IPMN without a suspected association.

AB - Background Intraductal papillary mucinous neoplasms (IPMN) have been reported to be associated with concurrent, distinct pancreatic ductal adenocarcinoma (con-PDAC) in about 8% (range, 4-10%) of resected branch duct (BD) lesions. In addition, other pancreatic and ampullary tumors are occasionally diagnosed with IPMN in patients undergoing pancreatic surgery. The objective of this study is to describe the prevalence, clinicopathologic characteristics and prognosis of IPMN with concurrent pancreatic and ampullary neoplasms, especially con-PDAC. Methods The combined databases of pancreatic resections from the Massachusetts General Hospital and the Negrar Hospital, Italy, were analyzed for patients who had been diagnosed with IPMN and concurrent pancreatic or ampullary neoplasms. Results 2762 patients underwent pancreatic surgery from January 2000 to December 2012. Sixteen percent (n = 441) had pathologically confirmed IPMN and 11% of these (n = 50) had a different distinct synchronous pancreatic neoplasm. The majority of these, 62%, were con-PDAC, followed by neuroendocrine neoplasms (10%) and ampullary carcinoma (10%). Less frequently, mucinous (6%) as well as serous cystic neoplasms (6%), adenosquamous carcinoma (4%) and distal bile duct cancer (2%) were diagnosed. Among all patients with synchronous neoplasms, 66% harbored BD-IPMN, 28% combined IPMN and 6% main duct IPMN. Abdominal pain and/or jaundice were the leading symptoms in half of patients. Conclusion IPMN, mainly BD-IPMN, are associated with con-PDAC in about 7% of patients and account for 62% of all concurrent pancreatic/ampullary neoplasms. Other synchronous neoplasms may be found sporadically with IPMN without a suspected association.

KW - Concurrent neoplasm

KW - Intraductal papillary mucinous noeplasm

KW - Pancreas

KW - Pancreatic cancer

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