Cyst Growth Rate Predicts Malignancy in Patients With Branch Duct Intraductal Papillary Mucinous Neoplasms

Mee Joo Kang, Jin Young Jang, Soo Jin Kim, Kyoung Bun Lee, Ji Kon Ryu, Yong Tae Kim, Yong Bum Yoon, Sun Whe Kim

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138 Scopus citations

Abstract

Background & Aims: Little information is available about the clinico-pathologic characteristics of pancreatic branch duct intraductal papillary mucinous neoplasm (Br-intraductal papillary mucinous neoplasm [IPMN]) because of difficulties in diagnosis based on radiologic and tissue information. We investigated the natural history of Br-IPMN using imaging and surgical pathology data from patients. Methods: Data were collected from patients admitted to a single tertiary referral institution from January 2000 to March 2009 (median follow up of 27.9 months); 201 patients were diagnosed with Br-IPMN with an initial cyst less than 30 mm without main pancreatic duct dilatation or mural nodules. The patients were followed for more than 3 months and examined by computed tomography (CT) at least twice. Results: The mean size of the patients' initial cysts was 14.7 mm; the mean cyst growth rate was 1.1 mm/year. Thirty-five patients received surgery during follow up and 8 were confirmed to have malignant cysts. The malignant cysts were greater in final size than nonmalignant cysts (24.3 mm vs 16.9 mm; P = .003); they also grew by a greater percentage (69.8% vs 19.4%; P = .046) and at a greater rate (4.1 mm vs 1.0 mm/year; P = .001). The actuarial 5-year risk of malignancy was 41.6% in the group that received surgery and 10.9% for all patients. Cysts that grew more than 2 mm/year had a higher risk of malignancy (5-year risk = 45.5% vs 1.8%; P < .001). Conclusions: In combination with cyst size and the presence of mural nodules, cyst growth rate could be used to predict malignancy in patients with Br-IPMN.

Original languageEnglish
Pages (from-to)87-93
Number of pages7
JournalClinical Gastroenterology and Hepatology
Volume9
Issue number1
DOIs
StatePublished - 1 Jan 2011

Keywords

  • MPD, main pancreatic duct
  • MRCP, magnetic resonance cholangiopancreatography
  • intraductal papillary mucinous neoplasm

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