Long-term follow up results of intraductal papillary mucinous tumors of pancreas

Background and Aim: Intraductal papillary mucinous tumor (IPMT) of the pancreas can be divided into three clinically distinct subtypes: main duct type, branch duct type and mixed type. Although it has been reported that the branch duct type IPMT is less invasive than the main duct type IPMT, we experienced a number of branch duct type IPMT having a poor prognosis. In the present study we surveyed the survival and recurrence rates according to the subtypes. Methods: Sixty-seven IPMT cases were studied to investigate clinical behavior according to the duct types. Diagnostic findings and late results of treatment were reviewed in 27 cases of the main duct type IPMT and in 35 cases of the branch duct type IPMT. Results: There was no statistically significant difference in the survival analysis between the main duct type IPMT and the branch duct type IPMT (P = 0.93). Seven patients (25.9%) died among the main duct type IPMT while six patients (17.1%) died among the branch duct type IPMT (P = 0.36). Tumor recurrence was noticed in four patients (18.1%) among 22 operated main duct type IPMT and in two patients (6.9%) among 29 operated branch duct type IPMT (P = 0.35). Conclusion: The long-term follow up result of the branch duct type IPMT is similar to that of the main duct type IPMT. Therefore, it is not safe just to monitor the branch duct type IPMT without operation. Surgery, whenever possible, is clearly the gold standard for treatment of IPMT, regardless of duct type. (C) 2005 Blackwell Publishing Asia Pty Ltd.