The prognosis of intraductal papillary mucinous tumors of the pancreas

Background/Aims: Intraductal papillary mucinous tumors of the pancreas have been recognized as a distinct clinical entity. However, their biological b ehavior has not been clearly defined. The aim of this study was to examine the prognosis of this tumor, to clarify the biological behavior and determi ne the most appropriate treatment. Methodology: Correlations between prognosis of operated cases and histopath ologic features were investigated. Results: In 105 patients with characteristic clinical features of intraduct al papillary mucinous tumors, the lesions were classified as hyperplasias i n 21%, intraductal tumors in 48% and invasive carcinomas in 31%. Minimal in vasion was apparent in 25%, lymph node metastasis in 21%, and fistula forma tion in 31% of the invasive lesions. Non-invasive and minimally invasive in traductal papillary mucinous tumors were essentially free from risk of tumo r recurrence. Other invasive intraductal papillary mucinous tumors showed a significantly poor prognosis. Conclusions: Because of the variation in pathological characteristics, pati ent outcome and the possibility of differential diagnosis, the treatment mi ght be recommended as follows: the case of hyperplasia can be followed-up w ith close surveillance. Non-invasive and minimally invasive intraductal pap illary mucinous tumors should be operated with function-preserving minimal pancreatectomy. For patients with invasive intraductal papillary mucinous t umors evident with preoperative imaging modalities, radical operations with lymph node dissection might be needed.