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Experience-based surgical approach to pancreatic mucinous cystic neoplasms with ovarian-type stroma

Authors
 Chang Moo Kang  ;  Akira Matsushita  ;  Ho Kyoung Hwang  ;  Yoko Matsuda  ;  Hyunki Kim  ;  Yoshiharu Nakamura  ;  Woo Jung Lee 
Citation
 Oncology Letters, Vol.15(2) : 2451-2458, 2018 
Journal Title
 Oncology Letters 
ISSN
 1792-1074 
Issue Date
2018
Keywords
laparoscopic ; mucinous cystic neoplasm ; pancreatectomy ; robotic
Abstract
The present study aimed to elucidate the clinicopathological characteristics of resected mucinous cystic neoplasm (MCN) with ovarian-type stroma and identify a surgical approach for MCN treatment, on the basis of Republic of Korean (Yonsei University College of Medicine, Seoul, South Korea) and Japanese (Nippon Medical School, Tokyo, Japan) bi-institutional collaboration. The present study retrospectively reviewed 55 MCNs with ovarian-type stroma using pathological re-examination. Clinicopathological features and preoperative clinical parameters were evaluated to predict malignant alterations in MCNs. The proportion of surgically treated MCNs has recently been increasing. All patients included in the present study were female, with a mean age of 47.9+/-13.3 years. Mural nodules were noted in 8 patients (14.5%) and the mean cyst size was 6.1+/-4.2 cm. A total of 9 patients (16.4%) were identified to exhibit non-invasive mucinous cystadenocarcinoma. The number of patients with small tumors (R(2)=-0.079, P=0.038) and asymptomatic pancreatic MCNs (P=0.022) was significantly increased (P<0.05), which resulted in the more frequent application of minimally invasive surgery (P<0.001). During the follow-up period (mean, 51.6 months; range, 1.1-242.8 months), no recurrence or tumor-associated mortality was identified. The presence of mural nodules (P=0.002) and a tumor size >/=4.5 cm (P=0.027) were identified as potential clinical parameters for predicting malignant transformation. The significance of mural nodules in predicting malignant transformation was increased in large MCNs (>/=4.5 cm) of the pancreas compared with small MCNs (<4.5 cm) (P=0.002). Overall, non-invasive pancreatic MCNs are not aggressive, and minimally invasive pancreatectomy may be an effective approach for suitable patients.
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T201800239.pdf Download
DOI
10.3892/ol.2017.7627
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161921
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