Intraductal papillary mucinous neoplasms of the pancreas

An increasingly recognized clinicopathologic entity

Taylor A. Sohn, Charles J. Yeo, John L. Cameron, Christine A. Iacobuzio-Donahue, Ralph H. Hruban, Keith D. Lillemoe

Research output: Contribution to journalArticle

285 Citations (Scopus)

Abstract

Objective: To assess the authors' experience with intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Summary Background Data: Intraductal papillary mucinous neoplasms of the pancreas are being recognized with increasing frequency. Methods: All patients who underwent pancreatic resection for an IPMN at the Johns Hopkins Hospital between January 1987 and December 2000 were studied. The data were compared with those of 702 concurrent patients with infiltrating ductal adenocarcinoma of the pancreas not associated with an IPMN resected by pancreaticoduodenectomy. Results: In the 13-year time period, 60 patients underwent pancreatic resection for IPMNs, with 40 patients undergoing resection in the past 3 years. Mean age at presentation was 67.4 ± 1.4 years. The most common presenting symptom in patients with IPMNs was abdominal pain (59%). Most IPMNs were in the head of the pancreas or diffusely involved the gland, with 70% being resected via pancreaticoduodenectomy, 22% via total pancreatectomy, and 8% via distal pancreatectomy. Twenty-two patients (37%) had IPMNs with an associated infiltrating adenocarcinoma. In a subset of IPMNs immunohistochemically stained for the Dpc4 protein (n = 50), all of the intraductal or noninvasive components strongly expressed Dpc4, whereas 84% of associated infiltrating cancers expressed Dpc4. The 5-year survival rate for all patients with IPMNs (n = 60) was 57%. Conclusion: Intraductal papillary mucinous neoplasms represent a distinct clinicopathologic entity being recognized with increasing frequency. IPMNs are clinically, histologically, and genetically disparate from pancreatic ductal adenocarcinomas. The distinct clinical features, the presumably long in situ or noninvasive phase, and the good long-term survival of patients with IPMNs offer a unique opportunity for early diagnosis, curative resection, and further studies of the molecular genetics and natural history of these unusual neoplasms.

Original languageEnglish (US)
Pages (from-to)313-322
Number of pages10
JournalAnnals of Surgery
Volume234
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Pancreatic Neoplasms
Adenocarcinoma
Pancreatectomy
Pancreaticoduodenectomy
Pancreas
Neoplasms
Abdominal Pain
Molecular Biology
Early Diagnosis
Survival Rate

ASJC Scopus subject areas

  • Surgery

Cite this

Sohn, T. A., Yeo, C. J., Cameron, J. L., Iacobuzio-Donahue, C. A., Hruban, R. H., & Lillemoe, K. D. (2001). Intraductal papillary mucinous neoplasms of the pancreas: An increasingly recognized clinicopathologic entity. Annals of Surgery, 234(3), 313-322. https://doi.org/10.1097/00000658-200109000-00005

Intraductal papillary mucinous neoplasms of the pancreas : An increasingly recognized clinicopathologic entity. / Sohn, Taylor A.; Yeo, Charles J.; Cameron, John L.; Iacobuzio-Donahue, Christine A.; Hruban, Ralph H.; Lillemoe, Keith D.

In: Annals of Surgery, Vol. 234, No. 3, 2001, p. 313-322.

Research output: Contribution to journalArticle

Sohn, TA, Yeo, CJ, Cameron, JL, Iacobuzio-Donahue, CA, Hruban, RH & Lillemoe, KD 2001, 'Intraductal papillary mucinous neoplasms of the pancreas: An increasingly recognized clinicopathologic entity', Annals of Surgery, vol. 234, no. 3, pp. 313-322. https://doi.org/10.1097/00000658-200109000-00005
Sohn, Taylor A. ; Yeo, Charles J. ; Cameron, John L. ; Iacobuzio-Donahue, Christine A. ; Hruban, Ralph H. ; Lillemoe, Keith D. / Intraductal papillary mucinous neoplasms of the pancreas : An increasingly recognized clinicopathologic entity. In: Annals of Surgery. 2001 ; Vol. 234, No. 3. pp. 313-322.
@article{d6efbfd876a4423e8f2b57dc90481816,
title = "Intraductal papillary mucinous neoplasms of the pancreas: An increasingly recognized clinicopathologic entity",
abstract = "Objective: To assess the authors' experience with intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Summary Background Data: Intraductal papillary mucinous neoplasms of the pancreas are being recognized with increasing frequency. Methods: All patients who underwent pancreatic resection for an IPMN at the Johns Hopkins Hospital between January 1987 and December 2000 were studied. The data were compared with those of 702 concurrent patients with infiltrating ductal adenocarcinoma of the pancreas not associated with an IPMN resected by pancreaticoduodenectomy. Results: In the 13-year time period, 60 patients underwent pancreatic resection for IPMNs, with 40 patients undergoing resection in the past 3 years. Mean age at presentation was 67.4 ± 1.4 years. The most common presenting symptom in patients with IPMNs was abdominal pain (59{\%}). Most IPMNs were in the head of the pancreas or diffusely involved the gland, with 70{\%} being resected via pancreaticoduodenectomy, 22{\%} via total pancreatectomy, and 8{\%} via distal pancreatectomy. Twenty-two patients (37{\%}) had IPMNs with an associated infiltrating adenocarcinoma. In a subset of IPMNs immunohistochemically stained for the Dpc4 protein (n = 50), all of the intraductal or noninvasive components strongly expressed Dpc4, whereas 84{\%} of associated infiltrating cancers expressed Dpc4. The 5-year survival rate for all patients with IPMNs (n = 60) was 57{\%}. Conclusion: Intraductal papillary mucinous neoplasms represent a distinct clinicopathologic entity being recognized with increasing frequency. IPMNs are clinically, histologically, and genetically disparate from pancreatic ductal adenocarcinomas. The distinct clinical features, the presumably long in situ or noninvasive phase, and the good long-term survival of patients with IPMNs offer a unique opportunity for early diagnosis, curative resection, and further studies of the molecular genetics and natural history of these unusual neoplasms.",
author = "Sohn, {Taylor A.} and Yeo, {Charles J.} and Cameron, {John L.} and Iacobuzio-Donahue, {Christine A.} and Hruban, {Ralph H.} and Lillemoe, {Keith D.}",
year = "2001",
doi = "10.1097/00000658-200109000-00005",
language = "English (US)",
volume = "234",
pages = "313--322",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Intraductal papillary mucinous neoplasms of the pancreas

T2 - An increasingly recognized clinicopathologic entity

AU - Sohn, Taylor A.

AU - Yeo, Charles J.

AU - Cameron, John L.

AU - Iacobuzio-Donahue, Christine A.

AU - Hruban, Ralph H.

AU - Lillemoe, Keith D.

PY - 2001

Y1 - 2001

N2 - Objective: To assess the authors' experience with intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Summary Background Data: Intraductal papillary mucinous neoplasms of the pancreas are being recognized with increasing frequency. Methods: All patients who underwent pancreatic resection for an IPMN at the Johns Hopkins Hospital between January 1987 and December 2000 were studied. The data were compared with those of 702 concurrent patients with infiltrating ductal adenocarcinoma of the pancreas not associated with an IPMN resected by pancreaticoduodenectomy. Results: In the 13-year time period, 60 patients underwent pancreatic resection for IPMNs, with 40 patients undergoing resection in the past 3 years. Mean age at presentation was 67.4 ± 1.4 years. The most common presenting symptom in patients with IPMNs was abdominal pain (59%). Most IPMNs were in the head of the pancreas or diffusely involved the gland, with 70% being resected via pancreaticoduodenectomy, 22% via total pancreatectomy, and 8% via distal pancreatectomy. Twenty-two patients (37%) had IPMNs with an associated infiltrating adenocarcinoma. In a subset of IPMNs immunohistochemically stained for the Dpc4 protein (n = 50), all of the intraductal or noninvasive components strongly expressed Dpc4, whereas 84% of associated infiltrating cancers expressed Dpc4. The 5-year survival rate for all patients with IPMNs (n = 60) was 57%. Conclusion: Intraductal papillary mucinous neoplasms represent a distinct clinicopathologic entity being recognized with increasing frequency. IPMNs are clinically, histologically, and genetically disparate from pancreatic ductal adenocarcinomas. The distinct clinical features, the presumably long in situ or noninvasive phase, and the good long-term survival of patients with IPMNs offer a unique opportunity for early diagnosis, curative resection, and further studies of the molecular genetics and natural history of these unusual neoplasms.

AB - Objective: To assess the authors' experience with intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Summary Background Data: Intraductal papillary mucinous neoplasms of the pancreas are being recognized with increasing frequency. Methods: All patients who underwent pancreatic resection for an IPMN at the Johns Hopkins Hospital between January 1987 and December 2000 were studied. The data were compared with those of 702 concurrent patients with infiltrating ductal adenocarcinoma of the pancreas not associated with an IPMN resected by pancreaticoduodenectomy. Results: In the 13-year time period, 60 patients underwent pancreatic resection for IPMNs, with 40 patients undergoing resection in the past 3 years. Mean age at presentation was 67.4 ± 1.4 years. The most common presenting symptom in patients with IPMNs was abdominal pain (59%). Most IPMNs were in the head of the pancreas or diffusely involved the gland, with 70% being resected via pancreaticoduodenectomy, 22% via total pancreatectomy, and 8% via distal pancreatectomy. Twenty-two patients (37%) had IPMNs with an associated infiltrating adenocarcinoma. In a subset of IPMNs immunohistochemically stained for the Dpc4 protein (n = 50), all of the intraductal or noninvasive components strongly expressed Dpc4, whereas 84% of associated infiltrating cancers expressed Dpc4. The 5-year survival rate for all patients with IPMNs (n = 60) was 57%. Conclusion: Intraductal papillary mucinous neoplasms represent a distinct clinicopathologic entity being recognized with increasing frequency. IPMNs are clinically, histologically, and genetically disparate from pancreatic ductal adenocarcinomas. The distinct clinical features, the presumably long in situ or noninvasive phase, and the good long-term survival of patients with IPMNs offer a unique opportunity for early diagnosis, curative resection, and further studies of the molecular genetics and natural history of these unusual neoplasms.

UR - http://www.scopus.com/inward/record.url?scp=0034857973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034857973&partnerID=8YFLogxK

U2 - 10.1097/00000658-200109000-00005

DO - 10.1097/00000658-200109000-00005

M3 - Article

VL - 234

SP - 313

EP - 322

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 3

ER -