Invasive IPMN relapse later and more often in lungs in comparison to pancreatic ductal adenocarcinoma.

Adenocarcinoma, Mucinous / pathology Carcinoma, Pancreatic Ductal / pathology Humans Lung Neoplasm Recurrence, Local / epidemiology Pancreatic Intraductal Neoplasms Pancreatic Neoplasms / surgery Retrospective Studies Pancreatic Neoplasms
Invasive intraductal papillary mucinous neoplasm Pancreatic ductal adenocarcinoma Recurrence pattern

Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 09 11 2021
revised: 09 05 2022
accepted: 25 05 2022
pubmed: 15 6 2022
medline: 15 9 2022
entrez: 14 6 2022
Statut: ppublish

Résumé

The different oncological outcomes of invasive intraductal papillary mucinous neoplasm (I-IPMN) and pancreatic ductal adenocarcinoma (PDAC) are debated. This study aimed to compare disease recurrence patterns and histopathological characteristics in patients with resected I-IPMN and PDAC. Consecutive patients undergoing surgical resection for stage I-III I-IPMN or PDAC between 2010 and 2016 were retrospectively analyzed. Patients treated with neoadjuvant therapy or resected for Tis neoplasia were excluded. All surgical specimens were re-staged according to AJCC-8th-edition. A total of 330 patients were included, of whom 43 had I-IPMN and 287 had PDAC. Median follow-up time was 26.7 (1.3-92.3) months and estimated median disease-free survival (DFS) was 60.3 months (47.2-73.4) for I-IPMN and 23.8 (19.3-28.2) months for PDAC (p < 0.001). During follow-up, 32.6% of I-IPMN and 67.9% of PDAC patients experienced recurrence (p < 0.001). The sites of first recurrence were the lungs (38.5% vs 13.1%, p = 0.027), liver (28.6% vs 45.0%, p = 0.180) and local (15.4% vs 36.6%, p = 0.101) for I-IPMN and PDAC, respectively. At multivariate analysis, I-IPMN histology remained an independent predictive factor for longer DFS (OR 0.528, CI 95% 0.278-1.000, p = 0.050), regardless of stage or adjuvant chemotherapy. I-IPMN and PDAC differed in rates of neuroinvasion (51.2% vs 97.2%) and positive lymph node status (N+) (46.5% vs 82.7%), especially in patients with lower T status. I-IPMN showed a different recurrence pattern compared to PDAC, with a higher lung tropism, and longer DFS. This different biological behavior is associated with lower rates of neuroinvasion and nodal involvement, especially in early-stage disease.

Sections du résumé

BACKGROUND BACKGROUND
The different oncological outcomes of invasive intraductal papillary mucinous neoplasm (I-IPMN) and pancreatic ductal adenocarcinoma (PDAC) are debated. This study aimed to compare disease recurrence patterns and histopathological characteristics in patients with resected I-IPMN and PDAC.
METHODS METHODS
Consecutive patients undergoing surgical resection for stage I-III I-IPMN or PDAC between 2010 and 2016 were retrospectively analyzed. Patients treated with neoadjuvant therapy or resected for Tis neoplasia were excluded. All surgical specimens were re-staged according to AJCC-8th-edition.
RESULTS RESULTS
A total of 330 patients were included, of whom 43 had I-IPMN and 287 had PDAC. Median follow-up time was 26.7 (1.3-92.3) months and estimated median disease-free survival (DFS) was 60.3 months (47.2-73.4) for I-IPMN and 23.8 (19.3-28.2) months for PDAC (p < 0.001). During follow-up, 32.6% of I-IPMN and 67.9% of PDAC patients experienced recurrence (p < 0.001). The sites of first recurrence were the lungs (38.5% vs 13.1%, p = 0.027), liver (28.6% vs 45.0%, p = 0.180) and local (15.4% vs 36.6%, p = 0.101) for I-IPMN and PDAC, respectively. At multivariate analysis, I-IPMN histology remained an independent predictive factor for longer DFS (OR 0.528, CI 95% 0.278-1.000, p = 0.050), regardless of stage or adjuvant chemotherapy. I-IPMN and PDAC differed in rates of neuroinvasion (51.2% vs 97.2%) and positive lymph node status (N+) (46.5% vs 82.7%), especially in patients with lower T status.
CONCLUSION CONCLUSIONS
I-IPMN showed a different recurrence pattern compared to PDAC, with a higher lung tropism, and longer DFS. This different biological behavior is associated with lower rates of neuroinvasion and nodal involvement, especially in early-stage disease.

Identifiants

DOI: 10.1016/j.pan.2022.05.006 PMID: 35701318
pubmed: 35701318
pii: S1424-3903(22)00173-9
doi: 10.1016/j.pan.2022.05.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

782-788

Informations de copyright

Copyright © 2022 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Giovanni Capretti (G)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Rozzano, Pieve Emanuele, Milan, Italy.

Martina Nebbia (M)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Rozzano, Pieve Emanuele, Milan, Italy. Electronic address: martina.nebbia@humanitas.it.

Francesca Gavazzi (F)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.

Gennaro Nappo (G)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Rozzano, Pieve Emanuele, Milan, Italy.

Cristina Ridolfi (C)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.

Mauro Sollai (M)

Department of Pathology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.

Paola Spaggiari (P)

Department of Pathology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.

Silvia Bozzarelli (S)

Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.

Silvia Carrara (S)

Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.

Antonio Luberto (A)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Rozzano, Pieve Emanuele, Milan, Italy.

Alessandro Zerbi (A)

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Rozzano, Pieve Emanuele, Milan, Italy.

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Classifications MeSH

questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Tumeurs kystiques, mucineuses et séreuses › Adénocarcinome mucineux › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Carcinome du canal pancréatique › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Appareil respiratoire › Poumon › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Tumeurs intracanalaires pancréatiques › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Invasive IPMN relapse later and more often in...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Invasive IPMN relapse later and more often in...