Abstract
Background
It is unclear whether invasive intraductal papillary mucinous neoplasm (IPMN) has
different clinical and prognostic characteristics, beyond histological factors, when
compared to pancreatic ductal adenocarcinoma (PDAC).
Aims
compare prognostic features of resected PDAC and invasive IPMN
Methods
A retrospective study of patients resected for PDAC or invasive IPMN realized at Humanitas
Cancer Center's Pancreatic Surgery Unit, Milan, Italy, between 2010 and 2016. Data
recorded included patient demographics, onset symptoms, preoperative health status,
tumor features, histology and surgical characteristics. Overall survival was estimated
using Kaplan-Meier and prognostic factors for survival were assessed by multivariate
Cox regression.
Results
A total of 332 patients were included (PDAC, n = 289; invasive IPMN, n = 43). Patients with invasive IPMN had better overall survival than PDAC patients
(median: 76.6 versus 25.6 months; 5-year OS rate: 65.4% vs. 14.2%; p < 0.001). PDAC histology was associated with a significantly higher risk of death
than IPMN (hazard ratio 1.815, 95% CI: 1.02, 3.24; p = 0.044). Survival was also worse with PDAC in early-stage disease (IA-IB-IIA, N0).
In multivariate analysis, independent predictors of worse survival included perineural
invasion, preoperative ASA physical status ≥3 and pain at diagnosis.
Conclusions
Patients with IPMN had a better prognosis than PDAC patients, regardless of disease
stage.
Keywords
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Article info
Publication history
Published online: July 01, 2021
Accepted:
June 10,
2021
Received:
January 26,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
