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논문 기본 정보

자료유형
학술저널
저자정보
Ji Eun Kwon (Sungkyunkwan University College of Medicine) Kee-Taek Jang (Sungkyunkwan University College of Medicine) Youngju Ryu (Sungkyunkwan University College of Medicine) Naru Kim (Sungkyunkwan University College of Medicine) Sang Hyun Shin (Sungkyunkwan University College of Medicine) Jin Seok Heo (Sungkyunkwan University College of Medicine) Dong Wook Choi (Sungkyunkwan University College of Medicine) In Woong Han (Sungkyunkwan University College of Medicine)
저널정보
한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제23권 제4호
발행연도
2019.11
수록면
365 - 371 (7page)

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Backgrounds/Aims: Although intraductal papillary mucinous neoplasm (IPMN) has showed a favorable prognosis compared to pancreatic ductal adenocarcinoma, its recurrence patterns have somewhat questionable in detail. After partial pancreatectomy for IPMN, the evaluation for risk of metachronous occurrence of high-risk lesions (HRL) in the residual pancreas is important to establish a postoperative surveillance modality and duration of follow-up. This study aimed to evaluate the factors that may predict the metachronous occurrence of HRL in the remnant pancreas after surgery of the IPMN. Methods: From 2005 to 2016, clinicopathologic and surveillance data for 346 consecutive patients who underwent surgical resection for IPMN were reviewed retrospectively. Histologic subtype was classified as gastric, intestinal, pancreato-biliary, or oncocytic type. Results: All of IPMN were classified as main duct (n=64, 18.5%), branch duct (n=171, 49.4%), and mixed type (n=111, 32.1%). Forty-eight patients (13.9%) experienced recurrence during follow-up. Among these, 9 patients (2.6%) were identified to metachronous development of HRL in the remnant pancreas. After multivariate analysis, high-grade dysplasia (HGD) or invasive carcinoma (IC) compared to low- or intermediate dysplasia was only independent risk factor for recurrence (HR 3.688, 95% CI 2.124- 12.524, p=0.009). The independent risk factors for metachronous development were HGD/IC (HR 8.414, 95% CI 4.310- 16.426, p=0.001), and intestinal/pancreato-biliary subtype compared to gastric subtype (HR 7.874, 95% CI 3.650- 27.027, p=0.010). Conclusions: Patients with high-grade dysplasia or invasive carcinoma, and with intestinal or pancreatobiliary subtype should undergo close, long-term surveillance of the remnant pancreas after initial resection.

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INTRODUCTION
PATIENTS AND METHODS
RESULTS
DISCUSSION
REFERENCES

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