Date K, et al. - This study was planned to determine the incidence and timing of development of concomitant pancreatic ductal adenocarcinoma (PDAC) in patients with and without pancreatectomy for intraductal papillary mucinous neoplasm (IPMN). Researchers identified the potential for development of concomitant PDAC in patients with IPMN suggesting long-term (≥5-year) surveillance as necessary and important. They observed that patients having a history of resection of concomitant PDAC at the time of the initial operation were at quite high risk for the development of secondary PDAC.

Methods

• Researchers performed a retrospective review of the surveillance data for 22 patients who underwent pancreatectomy for PDAC concomitant with IPMN (PDAC-resection group), 180 who underwent pancreatectomy for IPMN (IPMN-resection group), and 263 whose IPMNs were left untreated (non-resection group).
• They used the Kaplan–Meier method to investigate the incidence and timing of the development of a concomitant PDAC during the surveillance of patients with and without partial pancreatectomy for IPMN.

Results

• The median surveillance period was of 40 months (range 6–262 months); during this period 5 patients in the PDAC-resection group, 6 in the IPMN-resection group, and 8 in the non-resection group developed concomitant PDAC.
• The PDAC-resection group indicated significantly greater estimated 5-year (17%) and 10-year (56%) cumulative incidences of secondary PDAC compared to those in the other two groups (p < 0.01).
• Conversely, the IPMN-resection and non-resection groups indicated no significant difference in the estimated cumulative incidence of concomitant PDAC (5-year, 5.0% vs. 2.2%; 10-year, 5.0% vs. 8.7%; p=0.87).