Peritoneal Metastases After Intraductal Papillary Mucinous Neoplasm Resection: How Common are They?

Mohammed O. Suraju; Anthony Snow; Apoorve Nayyar; Jeremy Chang; Scott K. Sherman; Hisakazu Hoshi; James R. Howe; Carlos H.F. Chan

doi:10.1016/j.jss.2022.11.010

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Peritoneal Metastases After Intraductal Papillary Mucinous Neoplasm Resection: How Common are They?

Journal article

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Peer reviewed

Peritoneal Metastases After Intraductal Papillary Mucinous Neoplasm Resection: How Common are They?

Mohammed O. Suraju, Anthony Snow, Apoorve Nayyar, Jeremy Chang, Scott K. Sherman, Hisakazu Hoshi, James R. Howe and Carlos H.F. Chan

The Journal of surgical research, Vol.283, pp.479-484

03/2023

DOI: 10.1016/j.jss.2022.11.010

PMCID: PMC9877124

PMID: 36436283

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https://www.ncbi.nlm.nih.gov/pmc/articles/9877124View

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Abstract

Peritoneal metastases (PMs) following resection of pancreatic intraductal papillary mucinous neoplasms (IPMNs) are rare. Consequently, prevalence, risk factors, and prognosis are not well known. We reviewed our institution’s experience and published literature to further characterize the scope of this phenomenon. All pancreatectomy cases (556 patients) performed at a tertiary care center between 2010 and 2020 were reviewed to identify IPMN diagnoses. Patients with adenocarcinoma not arising from IPMN, or a history of other malignancies were excluded. Seventy-eight patients underwent pancreatectomy with IPMN on final pathology at our institution; 51 met inclusion criteria. Of these, there were five cases of PMs (4:1 females:males). Four had invasive carcinoma arising from IPMN and one had high-grade dysplasia at the index operation. Female sex and invasive histology were significantly associated with PM (P < 0.05). PM rates by sex were 3% (95% confidence interval [CI]: 0.5-15) in males and 22% (95% CI: 9-45) in females. Rates by histology were 2.9% (95% CI: 0.5-15) for noninvasive IPMN, and 23.5% (95% CI: 9.5-47) for invasive carcinoma arising from IPMN. Median interval from surgery to PMs was 7 mo (range: 3-13). PMs following IPMN resection are rare but may be more common in patients with invasive histology. Although rare, PMs can arise in patients with noninvasive IPMNs. Further studies on pathophysiology and risk factors of PM following IPMN resection are needed and may reinforce adherence to guidelines recommending long-term surveillance.

Dysplasia

Intraductal papillary mucinous neoplasm

Invasive carcinoma

Pancreatectomy

Peritoneal metastases

Details

Title: Subtitle: Peritoneal Metastases After Intraductal Papillary Mucinous Neoplasm Resection: How Common are They?
Creators: Mohammed O. Suraju - University of Iowa
Anthony Snow - University of Iowa
Apoorve Nayyar - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Jeremy Chang - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Scott K. Sherman - University of Iowa
Hisakazu Hoshi - University of Iowa
James R. Howe - University of Iowa
Carlos H.F. Chan - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The Journal of surgical research, Vol.283, pp.479-484
DOI: 10.1016/j.jss.2022.11.010
PMID: 36436283
PMCID: PMC9877124
NLM abbreviation: J Surg Res
ISSN: 0022-4804
eISSN: 1095-8673
Publisher: Elsevier Inc
Language: English
Date published: 03/2023
Academic Unit: Pathology; Surgery; Radiation Oncology
Record Identifier: 9984322932902771

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