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• W2977895792 abstract "Purpose: Factors which predict recurrence of branch duct IPMNs (BD-IPMNs) after surgical resection are not entirely known. We investigated the ability of cyst fluid molecular markers to predict post-surgical recurrence of these cysts. Methods: Patients who underwent surgical resection for BD-IPMNs and also had preoperative EUS with molecular analysis of the cystic fluid between April 2008 and May 2013 were identified from a dedicated EUS pancreas cyst database. Clinical, radiological, endoscopic and histological data were reviewed. Tumor recurrence was defined as development of new lesion in the pancreatic remnant or metastasis in extrapancreatic organs. Diagnosis of recurrence was made radiographically with CT or MRI and confirmed with EUS if indicated. Logistic regression analysis was performed to assess factors predicting recurrence of IPMNs. Results: Forty seven patients (55% males, mean age 66 + 10.5 years) with BD-IPMNs underwent surgical resection with follow up and were included. Thirteen (27.7%) patients had evidence of high grade dysplasia (19.1%) or invasive carcinoma (8.5%) on histology. Seven patients (14.9%) had post-operative recurrence confirmed. Mean recurrence free survival was 84.4 months. Of the seven patients with recurrence, four underwent confirmatory EUS, two developed new metastatic liver lesions and one patient was followed with serial imaging. The presence of high grade dysplasia or malignancy was associated with higher rate of recurrence (30.8% vs. 9.8%, p=0.039). All patients with recurrence had symptomatic IPMN prior to resection (19.4% vs. 0%). Molecular markers prior to the surgical resection were available in 35 (74.5 %) patients. Presence of K-ras mutation was not associated with increased risk of recurrence (17.6% vs. 11.1%, p=0.4). However, presence of K-ras mutation may be associated with a trend for earlier recurrence (Figure 1). Size of the tumor or IPMN-positive resection margin did not correlate with the disease recurrence.FigureConclusion: In our patient population, presence of high grade dysplasia or malignancy was associated with higher rate of post-operative recurrence. K-ras mutation may be associated with earlier recurrence." @default.
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• W2977895792 date "2013-10-01" @default.
• W2977895792 modified "2023-10-17" @default.
• W2977895792 title "Recurrence after Surgical Resection of Branch Duct Intraductal Papillary Mucinous Neoplasams (BD-IPMN)" @default.
• W2977895792 doi "https://doi.org/10.14309/00000434-201310001-00275" @default.
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