Invasive intraductal oncocytic papillary neoplasms (IOPN) and adenocarcimoma arising from intraductal papillary mucinous neoplasms (A-IPMN) of the pancreas: comparative analysis of clinicopathological features, patterns of recurrence and survival: a multicentre study.
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Lucocq James, Haugk Beate, Joseph Nejo, Hawkyard Jake, White Steve, Mownah Omar, Menon Krishna, Furukawa Takaki, Inoue Yosuke, Hirose Yuki, Sasahira Naoki, Mittal Anubhav, Samra Jas, Sheen Amy, Feretis Michael, Balakrishnan Anita, Ceresa Carlo, Davidson Brian, Pande Rupaly, Dasari Bobby V M, Tanno Lulu, Karavias Dimitrios, Helliwell Jack, Young Alistair, Nunes Quentin, Urbonas Tomas, Silva Michael, Gordon-Weeks Alex, Barrie Jenifer, Gomez Dhanny, van Laarhoven Stijn, Nawara Hossam, Doyle Joseph, Bhogal Ricky, Harrison Ewen, Roalso Marcus, Zaharia Claudia, Ciprani Debora, Aroori Somaiah, Ratnayake Bathiya, Koea Jonathan, Capurso Gabriele, Bellotti Ruben, Stättner Stefan, Alsaoudi Tareq, Bhardwaj Neil, Jeffery Fraser, Connor Saxon, Cameron Andrew, Jamieson Nigel, Roberts Keith, Soreide Kjetil, Gill Anthony J, Pandanaboyana Sanjay
Аннотация
METHODS: Consecutive patients undergoing pancreatic resection (2010-2020) for invasive IOPNs or adenocarcinoma arising from IPMN (A-IPMN) from 18 academic pancreatic centers worldwide were included. Outcomes of invasive IOPNs were compared with A-IPMN invasive subtypes (ductal and colloid A-IPMN).
RESULTS: 415 patients were included: 20 invasive IOPN, 331 ductal A-IPMN and 64 colloid A-IPMN. After a median follow-up of 6-years, 45% and 60% of invasive IOPNs had developed recurrence and died, respectively. There was no significant difference in recurrence or overall survival between invasive IOPN and ductal A-IPMN. Overall survival of invasive IOPNs was inferior to colloid A-IPMNs (median time of survival 24.4 months vs. 86.7, months, p = 0.013), but the difference in recurrence only showed borderline significance (median time to recurrence, 22.5 months vs. 78.5 months, p = 0.132). Adjuvant chemotherapy, after accounting for high-risk features, did not reduce rates of recurrence in invasive IOPN (p = 0.443), ductal carcinoma (p = 0.192) or colloid carcinoma (p = 0.574).
CONCLUSIONS: Invasive IOPNs should be considered an aggressive cancer with a recurrence rate and prognosis consistent with ductal type A-IPMN.