In:
European Surgical Research, S. Karger AG, Vol. 62, No. 4 ( 2021), p. 262-270
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 This study aimed to determine the preoperative clinicophysiological and postoperative clinicopathological predictors of malignancy in patients with intraductal papillary mucinous neoplasm (IPMN). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This was a retrospective observational study. We included 121 patients (73 men and 48 women; mean age: 68.7 years) who had undergone pancreatic resection for IPMN between 2007 and 2018. These patients were grouped into invasive carcinoma (IPMN-INV, 〈 i 〉 N 〈 /i 〉 = 21) and low/high-grade IPMN (IPMN-LG/HG, 〈 i 〉 N 〈 /i 〉 = 100) groups. Univariate and multivariate analyses of clinicophysiological parameters were carried out. These parameters were also compared between the IPMN-INV/HG ( 〈 i 〉 N 〈 /i 〉 = 53) and IPMN-LG ( 〈 i 〉 N 〈 /i 〉 = 68) groups. Survival analyses according to macroscopic type and IPMN subtypes were performed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 On univariate analysis, age ( 〈 i 〉 p 〈 /i 〉 = 0.038), carbohydrate antigen (CA) 19-9 ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), IPMN macroscopic type ( 〈 i 〉 p 〈 /i 〉 = 0.001), IPMN subtype ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), pancreatic duct diameter ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), and mural nodule ( 〈 i 〉 p 〈 /i 〉 = 0.042), between IPMN-INV and IPMN-LG/HG were found to be significant prognostic factors of malignancy. CA 19-9 was found to be an independent prognostic factor of IPMN malignancy on multivariate analysis ( 〈 i 〉 p 〈 /i 〉 = 0.035). The 1-, 3-, and 5-year overall survival (OS) rates of the IPMN-INV and IPMN-LG/HG groups were 94.4/100%, 94.4/100%, and 67.2/100%, respectively. The OS rate in the IPMN-LG/HG group was significantly higher than that in the IPMN-INV group ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). On univariate analysis, platelet ( 〈 i 〉 p 〈 /i 〉 = 0.043), CA 19-9 ( 〈 i 〉 p 〈 /i 〉 = 0.039), prognostic nutritional index ( 〈 i 〉 p 〈 /i 〉 = 0.034), platelet/lymphocyte ratio ( 〈 i 〉 p 〈 /i 〉 = 0.01), IPMN macroscopic type ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), IPMN subtype ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), pancreatic duct diameter ( 〈 i 〉 p 〈 /i 〉 = 0.036), and mural nodule ( 〈 i 〉 p 〈 /i 〉 = 0.032) between IPMN-INV/HG and IPMN-LG were found to be significant prognostic factors of malignancy. On multivariate analysis, CA 19-9 was found to be an independent prognostic factor ( 〈 i 〉 p 〈 /i 〉 = 0.042) between IPMN-INV/HG and IPMN-LG of malignancy. The 1-, 3-, and 5-year OS rates of the IPMN-INV/HG and IPMN-LG groups were 97.9/100%, 97.9/100%, and 82.6/100%, respectively. The OS rate was significantly higher in the IPMN-LG group than in the IPMN-INV/HG group ( 〈 i 〉 p 〈 /i 〉 = 0.03). No significant differences in survival were observed in patients with macroscopic tumors ( 〈 i 〉 p 〈 /i 〉 = 0.544). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 CA 19-9 is an independent invasive malignancy predictor of IPMN.
Type of Medium:
Online Resource
ISSN:
0014-312X
,
1421-9921
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
1468505-X
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