Oncological Outcomes and Patterns of Recurrence after the Surgical Resection of an Invasive Intraductal Papillary Mucinous Neoplasm versus Primary Pancreatic Ductal Adenocarcinoma: An Analysis from the German Cancer Registry Group of the Society of German Tumor Centers

被引:2
作者
Abdalla, Thaer S. A. [1 ,2 ]
Duhn, Jannis [1 ,2 ]
Klinkhammer-Schalke, Monika [2 ]
Zeissig, Sylke Ruth [2 ,3 ]
Kleihues-van Tol, Kees [2 ]
Honselmann, Kim C. [1 ,2 ]
Braun, Rudiger [1 ,2 ]
Kist, Markus [1 ,2 ]
Bolm, Louisa [1 ,2 ]
von Fritsch, Lennart [1 ,2 ]
Lapshyn, Hryhoriy [1 ]
Litkevych, Stanislav [1 ]
Hummel, Richard [2 ,4 ]
Zemskov, Sergii [5 ]
Wellner, Ulrich Friedrich [1 ,2 ]
Keck, Tobias [1 ,2 ]
Deichmann, Steffen [1 ,2 ]
机构
[1] Univ Med Ctr Schleswig Holstein, Dept Surg, Campus Luebeck, D-23562 Lubeck, Germany
[2] Soc German Tumor Ctr, Network Care Qual & Res Oncol ADT, German Canc Registry Grp, D-14057 Berlin, Germany
[3] Univ Wurzburg, Inst Clin Epidemiol & Biometry ICE B, D-97974 Wurzburg, Germany
[4] Univ Med Ctr Greiswald, Dept Surg, D-17489 Greifswald, Germany
[5] Bogomolets Natl Med Univ, Dept Gen Surg, UA-01601 Kiev, Ukraine
关键词
IPMN; PDAC; patterns of recurrence; pancreatic cancer; PREDICTORS; SURVIVAL; THERAPY; IMPACT;
D O I
10.3390/cancers16112016
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Intraductal papillary mucinous neoplasms (IPMNs) are premalignant cystic neoplasms of the pancreas (CNPs), which can progress to invasive IPMN and pancreatic cancer. The available literature has shown controversial results regarding prognosis and clinical outcomes after the resection of invasive IPMN. Aims: This study aims to characterize the oncologic outcomes and metastatic progression pattern after the resection of non-metastatic invasive IPMN. Methods: Data were obtained from 24 clinical cancer registries participating in the German Cancer Registry Group of the Society of German Tumor Centers (ADT). Patients with invasive IPMN (n = 217) as well as PDAC (n = 5794) between 2000 and 2021 were included and compared regarding oncological outcomes. Results: Invasive IPMN was significantly smaller in size (p < 0.001) and of a lower tumor grade (p < 0.001), with fewer lymph node metastases (p < 0.001), lymphangiosis (p < 0.001), and consequently a higher R0 resection rate (88 vs. 74%) compared to PDAC. Moreover, invasive IPMN was associated with fewer local (11 vs. 15%) and distant recurrences (29 vs. 46%) and metastasized more frequently in the lungs only (26% vs. 14%). Invasive IPMN was associated with a longer median OS (29 vs. 19 months) and DFS (31 vs. 15 months) compared to PDAC and stayed independently prognostic in multivariable analyses. These survival differences were most pronounced in early tumor stages. Interestingly, postoperative chemotherapy was not associated with improved overall survival in surgically resected invasive IPMN. Conclusions: Invasive IPMN is a rare pancreatic entity with increasing incidence in Germany. It is associated with favorable histopathological features at the time of resection and longer OS and DFS compared to PDAC, particularly before the locoregional spread has occurred. Invasive IPMNs are associated with lung-only metastasis. The benefit of postoperative chemotherapy after the resection of invasive IPMN remains uncertain.
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