Surgery: Current Research

ISSN - 2161-1076


Evaluation of the Prognostic Significance of "High-risk Stigmata" in the International Consensus Guidelines 2012 for Intraductal Papillary Mucinous Neoplasm

Kenjiro Kimura *,Ryosuke Amano ,Sadaaki Yamazoe ,Go Ohira ,Kotaro Miura ,Kohei Nishio ,Katsunobu Sakurai ,Takahiro Toyokawa ,Bunzo Nakata ,Akihiro Murata ,Sadatoshi Shimizu ,Sayaka Tanaka ,Masahiko Ohsawa ,Masaichi Ohira ,Kosei Hirakawa

Study Background: In the International Consensus Guidelines 2012 for intraductal papillary mucinous neoplasm (IPMN), ‘high-risk stigmata’ (HRS) were described as indications for resection. The purpose of this study was to evaluate the prognostic meaning of HRS in the 2012 guidelines.

Method: Clinical and pathological data from 98 patients who underwent pancreatic resection for IPMN at our institution between 1994 and 2014 were retrospectively analyzed.

Results: The 98 resected IPMNs were categorized as demonstrating no criteria (NC) (n=18), worrisome features (WF) (n=39), or HRS (n=46) according to the guidelines. By multivariate analysis, positive lymph node metastasis and HRS were significantly identified as independent prognostic factors. Five-year disease-specific survival rates for NC and WF were both 100%, whereas that for HRS was significantly poorer at 49.5% (p<0.001 each).

Conclusions: In this retrospective analysis, HRS were an independent prognostic factor after surgical resection for IPMN. Moreover, HRS offered high diagnostic ability for detecting invasive IPMNs. These results strongly indicated that HRS had high possibility of invasive IPMN and worse prognosis.