This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (39)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Liver/ Biliary Tract/ Pancreatic Diseases  • Prognosis/ Outcomes  • Oncology, Other  • Alert me on articles by topic

Predictive Criteria of Malignancy According to Pathological Examination of 53 Cases

Pierre Bernard, MD; Jean-Yves Scoazec, MD,PhD; Madeleine Joubert, MD; Xavier Kahn, MD; Joël Le Borgne, MD; Françoise Berger, MD,PhD; Christian Partensky, MD

Arch Surg. 2002;137:1274-1278.

Background  One of the main problems in the management and treatment of intraductal papillary-mucinous tumors is the lack of a reliable predictive factor for malignancy.

Hypothesis  Surgical treatment could be adapted to macroscopic criteria (presence of mural nodules and diameter of the pancreatic duct and of the lesion) or to tumor location (main duct, branch duct, or combined lesions) associated with benign or malignant forms.

Design  Retrospective study.

Setting  Two university and tertiary referral centers.

Patients  Fifty-three consecutive patients who underwent pancreatic resection for intraductal papillary-mucinous tumors between January 1, 1985, and December 31, 2000.

Results  Macroscopic analyses of tumors showed 6 main duct lesions, 12 branch duct lesions, and 35 combined lesions. A carcinoma was present in 33 cases (62%): 22 (41%) were invasive and 11 (21%) were noninvasive; 9 (17%) were borderline tumors and 11 (21%) were benign. Carcinoma and invasive carcinoma forms were less frequent in branch duct lesions (P<.001 and P = .009, respectively). Mural nodules were more frequent in carcinomas (P = .006) and invasive carcinomas (P<.001), with a positive predictive value of malignancy of 81%. The diameter of lesions (branch duct lesion 30 mm) or main duct (main pancreatic duct 15 mm in combined or main pancreatic duct lesions) did not correlate with malignancy.

Conclusions  No carcinoma occurred in branch duct types smaller than 30 mm without mural nodules. Limited resection may be appropriate only in this type of tumor.

From the Departments of Surgery (Drs Bernard and Partensky) and Pathology (Drs Scoazec and Berger), Hospital E. Herriot, Lyon, France; and the Departments of Pathology (Dr Joubert) and Surgery (Drs Kahn and Le Borgne), Hôtel-Dieu, Nantes, France.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Intraductal Papillary Mucinous Neoplasm of the Pancreas: Assessment of the Likelihood of Invasiveness with Multisection CT
Ogawa et al.
Radiology 2008;248:876-886.
ABSTRACT | FULL TEXT  

Treatment Guidelines for Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas: When Can We Operate or Observe?
Jang et al.
Ann. Surg. Oncol. 2008;15:199-205.
ABSTRACT | FULL TEXT  

Malignant Intraductal Papillary Mucinous Neoplasm of the Pancreas: In Situ versus Invasive Carcinoma Surgical Resectability
Vullierme et al.
Radiology 2007;245:483-490.
ABSTRACT | FULL TEXT  

Characterization of Cystic Pancreatic Masses: Relative Accuracy of CT and MRI
Visser et al.
Am. J. Roentgenol. 2007;189:648-656.
ABSTRACT | FULL TEXT  

MDCT of Intraductal Papillary Mucinous Neoplasm of the Pancreas: Evaluation of Features Predictive of Invasive Carcinoma.
Kawamoto et al.
Am. J. Roentgenol. 2006;186:687-695.
ABSTRACT | FULL TEXT  

Intraductal Papillary Mucinous Neoplasm of the Pancreas: Can Benign Lesions Be Differentiated from Malignant Lesions with Multidetector CT?
Kawamoto et al.
RadioGraphics 2005;25:1451-1468.
ABSTRACT | FULL TEXT  

Multicenter Analysis of Clinicopathologic Features of Intraductal Papillary Mucinous Tumor of the Pancreas: Is It Possible to Predict the Malignancy Before Surgery?
Jang et al.
Ann. Surg. Oncol. 2005;12:124-132.
ABSTRACT | FULL TEXT