Long-term prognosis after resection of intraductal papillary mucinous neoplasms

Abstract

The strongest prognostic factor after resection of intraductal papillary mucinous neoplasms (IPMN) is the presence of invasive cancer. After resection of non-invasive IPMNs, the long-term prognosis is favorable, while extra-pancreatic recurrence or a residual pancreatic lesion might occur in some patients. Although patients with invasive IPMNs have shorter survival compared to those with non-invasive IPMNs, they have been reported to have a more favorable prognosis compared to conventional pancreatic ductal adenocarcinoma. This is probably due to detection at an earlier stage and a higher proportion of colloid carcinoma among invasive IPMNs. Residual pancreatic lesions after resection of IPMNs have increasingly been reported recently and several investigators reported risk/predictive factors. Among these, high-grade or invasive IPMNs were reported to be specific risk/predictive factors for lesions requiring resection. Regarding surveillance after resection of IPMNs, long-term surveillance considering development of residual pancreatic lesions is recommended although there are some differences in available guidelines.