Mucin-Producing Neoplasms of the Pancreas

An Analysis of Distinguishing Clinical and Epidemiologic Characteristics

Stefano Crippa, Carlos Fernández-del Castillo, Roberto Salvia, Dianne Finkelstein, Claudio Bassi, Ismael Domínguez, Alona Muzikansky, Sarah P Thayer, Massimo Falconi, Mari Mino-Kenudson, Paola Capelli, Gregory Y. Lauwers, Stefano Partelli, Paolo Pederzoli, Andrew L. Warshaw

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Abstract

Background & Aims: Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics. Methods: Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified. Results: One hundred sixty-eight patients (30%) had MCNs, 159 (28.5%) had branch-duct IPMNs, 149 (27%) had combined IPMNs, and 81 (14.5%) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44% of patients with main-duct or combined IPMNs and 57% of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95%); 11% were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11%, 42%, and 48% of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100% for patients with noninvasive MPNs. The rates for those with invasive cancer were 58%, 56%, 51%, and 64% for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively. Conclusions: MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Volume8
Issue number2
DOIs
StatePublished - Jan 1 2010

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Mucins
Pancreatic Neoplasms
Neoplasms
Pancreas

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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Crippa, S., Fernández-del Castillo, C., Salvia, R., Finkelstein, D., Bassi, C., Domínguez, I., ... Warshaw, A. L. (2010). Mucin-Producing Neoplasms of the Pancreas: An Analysis of Distinguishing Clinical and Epidemiologic Characteristics. Clinical Gastroenterology and Hepatology, 8(2). https://doi.org/10.1016/j.cgh.2009.10.001

Mucin-Producing Neoplasms of the Pancreas : An Analysis of Distinguishing Clinical and Epidemiologic Characteristics. / Crippa, Stefano; Fernández-del Castillo, Carlos; Salvia, Roberto; Finkelstein, Dianne; Bassi, Claudio; Domínguez, Ismael; Muzikansky, Alona; Thayer, Sarah P; Falconi, Massimo; Mino-Kenudson, Mari; Capelli, Paola; Lauwers, Gregory Y.; Partelli, Stefano; Pederzoli, Paolo; Warshaw, Andrew L.

In: Clinical Gastroenterology and Hepatology, Vol. 8, No. 2, 01.01.2010.

Research output: Contribution to journalArticle

Crippa, S, Fernández-del Castillo, C, Salvia, R, Finkelstein, D, Bassi, C, Domínguez, I, Muzikansky, A, Thayer, SP, Falconi, M, Mino-Kenudson, M, Capelli, P, Lauwers, GY, Partelli, S, Pederzoli, P & Warshaw, AL 2010, 'Mucin-Producing Neoplasms of the Pancreas: An Analysis of Distinguishing Clinical and Epidemiologic Characteristics', Clinical Gastroenterology and Hepatology, vol. 8, no. 2. https://doi.org/10.1016/j.cgh.2009.10.001
Crippa, Stefano ; Fernández-del Castillo, Carlos ; Salvia, Roberto ; Finkelstein, Dianne ; Bassi, Claudio ; Domínguez, Ismael ; Muzikansky, Alona ; Thayer, Sarah P ; Falconi, Massimo ; Mino-Kenudson, Mari ; Capelli, Paola ; Lauwers, Gregory Y. ; Partelli, Stefano ; Pederzoli, Paolo ; Warshaw, Andrew L. / Mucin-Producing Neoplasms of the Pancreas : An Analysis of Distinguishing Clinical and Epidemiologic Characteristics. In: Clinical Gastroenterology and Hepatology. 2010 ; Vol. 8, No. 2.
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abstract = "Background & Aims: Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics. Methods: Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified. Results: One hundred sixty-eight patients (30{\%}) had MCNs, 159 (28.5{\%}) had branch-duct IPMNs, 149 (27{\%}) had combined IPMNs, and 81 (14.5{\%}) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44{\%} of patients with main-duct or combined IPMNs and 57{\%} of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95{\%}); 11{\%} were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11{\%}, 42{\%}, and 48{\%} of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100{\%} for patients with noninvasive MPNs. The rates for those with invasive cancer were 58{\%}, 56{\%}, 51{\%}, and 64{\%} for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively. Conclusions: MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.",
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AU - Crippa, Stefano

AU - Fernández-del Castillo, Carlos

AU - Salvia, Roberto

AU - Finkelstein, Dianne

AU - Bassi, Claudio

AU - Domínguez, Ismael

AU - Muzikansky, Alona

AU - Thayer, Sarah P

AU - Falconi, Massimo

AU - Mino-Kenudson, Mari

AU - Capelli, Paola

AU - Lauwers, Gregory Y.

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AU - Pederzoli, Paolo

AU - Warshaw, Andrew L.

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N2 - Background & Aims: Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics. Methods: Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified. Results: One hundred sixty-eight patients (30%) had MCNs, 159 (28.5%) had branch-duct IPMNs, 149 (27%) had combined IPMNs, and 81 (14.5%) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44% of patients with main-duct or combined IPMNs and 57% of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95%); 11% were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11%, 42%, and 48% of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100% for patients with noninvasive MPNs. The rates for those with invasive cancer were 58%, 56%, 51%, and 64% for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively. Conclusions: MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.

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