Mucin-producing tumors of the pancreas: clinicopathological features, surgical treatment, and outcome |
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Authors: | Mitsuhiro Inagaki Masayuki Maguchi Shuichi Kino Mitsuhiro Obara Akira Ishizaki Kazuhiko Onodera Kazunori Yokoyama Isao Makino Hidenori Ojima Yoshihiko Tokusashi Naoyuki Miyokawa Shinichi Kasai |
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Affiliation: | Second Department of Surgery, Asahikawa Medical College, 4-5-3-11 Nishikagura, Asahikawa 078-8510, Japan, JP Second Department of Medicine, Asahikawa Medical College, Asahikawa, Japan, JP Department of Surgical Pathology, Asahikawa Medical College, Asahikawa, Japan, JP
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Abstract: | Mucin-producing tumors (MPTs) of the pancreas are increasingly being recognized. To evaluate the appropriate surgical treatment and predict the prognosis of MPTs, we performed a retrospective clinicopathological study in 51 patients, 27 with benign tumors and 24 with borderline/malignant tumors. Three of the malignant tumors showed stromal invasion and lymph node metastasis on histological examination. Of the 24 patients with borderline/malignant tumors, 2 died of MPTs and 4 died of other diseases. At the last follow-up, 35 patients were alive and well. The 5-year postoperative survival rate was 90% for patients with benign tumors, and 78% of these with borderline/malignant tumors. Five of the patients with borderline/malignant tumors had multicentric tumors. Three of these patients underwent resection of the rest of the pancreas, 5, 6, and 8 years, respectively, after the first operation. Extended radical resection is required for malignant MPT with invasion of the pancreatic stroma. We prefer to perform pancreatogastrostomy or Imanaga's procedure to allow examination of the body and tail of the pancreas by endoscopic retrograde pancreatography after resection of the pancreatic head. Careful follow-up for a long period may be the most prudent approach for detecting multiple MPTs in the residual pancreas after surgical treatment. |
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Keywords: | mucin-producing tumor pancreas pylorus-preserving pancreaticoduodenectomy duodenum-preserving pancreas head resection |
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