Pancreatic Adenocarcinoma Associated to Intraductal Papillary Mucinous Neoplasia: Histopathological Particularities and Clinical Implications

Chirurgia (Bucur). 2022 Jun;117(4):454-462. doi: 10.21614/chirurgia.2760.

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic tumor, known for an aggressive evolution. Intraductal papillary mucinous neoplasm (IPMN) is a rare pancreatic tumor, considered a premalignant lesion with the possibility of carcinogenesis towards PDAC. The clinical, surgical and histopathological particularities of the association between PDAC and IPMN are yet unknown, further research being needed. Methods: We have conducted a retrospective descriptive study, on a nine-year period (2012-2020), with the aim of comparing the characteristics of patients that underwent curative surgical interventions for solitary PDAC and PDAC associated to IPMN. Results: Fifteen patients with PDAC associated with IPMN (Group 1) and 386 patients with solitary PDAC (Group 2) were included in our study. Group 1 had a younger average age (61.8 years) compared to Group 2 (63.89 years). Total pancreatectomy was more frequently performed for Group 1 than Group 2 (33.33% vs 12.43%). Group 1 had a higher percentage of cases with positive perineural, perilymphatic and perivascular invasion. Group 1 registered a worse overall survival, as well as a worse short-time survival compared to Group 2. Conclusions: PDAC associated to IPMN registers distinct epidemiological, clinical and histopathological characteristics compared to solitary PDAC.

Keywords: intraductalpapillarymucinousneoplasm; pancreaticadenocarcinoma; pancreaticcancer; pancreaticsurgery.

MeSH terms

  • Adenocarcinoma* / pathology
  • Adenocarcinoma, Mucinous* / complications
  • Adenocarcinoma, Mucinous* / pathology
  • Adenocarcinoma, Mucinous* / surgery
  • Carcinoma, Pancreatic Ductal* / complications
  • Carcinoma, Pancreatic Ductal* / surgery
  • Humans
  • Middle Aged
  • Pancreatic Intraductal Neoplasms* / complications
  • Pancreatic Intraductal Neoplasms* / surgery
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / surgery
  • Retrospective Studies
  • Treatment Outcome