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

Matteo Piciucchi, Stefano Crippa, Marco Del Chiaro, Roberto Valente, Raffaele Pezzilli, Massimo Falconi, Gianfranco Delle Fave, Gabriele Capurso

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)584-588
Number of pages5
JournalDigestive and Liver Disease
Volume45
Issue number7
DOIs
Publication statusPublished - Jul 2013

Keywords

  • Conservative approach
  • Intraductal papillary mucinous neoplasms
  • Outcome
  • Sendai criteria

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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