caa a22 4500 445889098 CHVBK 20180317145610.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00535-010-0343-0 doi (NATIONALLICENCE)springer-10.1007/s00535-010-0343-0 Size of mural nodule as an indicator of surgery for branch duct intraductal papillary mucinous neoplasm of the pancreas during follow-up [Elektronische Daten] [Hiroyuki Uehara, Osamu Ishikawa, Kazuhiro Katayama, Natsuko Kawada, Kenji Ikezawa, Nobuyasu Fukutake, Rena Takakura, Yasuna Takano, Sachiko Tanaka, Akemi Takenaka] Background: A mural nodule is a strong predictive factor for malignancy in branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas, but the nodule size has hardly been considered. The aim of this study was to investigate whether a mural nodule of 10mm was appropriate as an indicator of surgery for IPMN during follow-up. Methods: The follow-up outcomes of 100 patients who had branch duct IPMN without mural nodules or who had branch duct IPMN with mural nodules of less than 9mm in a tertiary care setting were investigated retrospectively. The patients underwent abdominal ultrasound (US) every 3months and additional imaging examinations or cytologic examination of pancreatic juice when necessary. Surgery was recommended to them when a mural nodule developed or when a nodule enlarged and reached 10mm. Results: During an average follow-up period of 97months, branch duct IPMNs developed mural nodules that reached 10mm in 5 patients (0.62% per year). In one patient the IPMN was revealed to be non-invasive carcinoma by resection, 1 IPMN was shown to be malignant by further follow-up, and 3 were not resected because of refusal or the patient's age. In 7 patients, mural nodules stayed within 9mm. The remaining 88 patients lacked mural nodules in their branch duct IPMNs throughout the follow-up. The occurrence of invasive carcinoma around the IPMN was not indicated by imaging examinations in any patient. Univariate analysis showed that the size of the cyst at baseline significantly predicted the development of a mural nodule that reached 10mm during follow-up (P=0.05). Conclusions: A mural nodule of 10mm is appropriate as an indicator of surgery in the follow-up of branch duct IPMN. Springer, 2010 Pancreas nationallicence Branch duct IPMN nationallicence Follow-up nationallicence Mural nodule nationallicence IPMN : Intraductal papillary mucinous neoplasm nationallicence US : Ultrasound nationallicence EUS : Endoscopic ultrasound nationallicence CT : Computed tomography nationallicence ERCP : Endoscopic retrograde cholangiopancreatography nationallicence MRCP : Magnetic resonance cholangiopancreatography nationallicence Uehara Hiroyuki Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut Ishikawa Osamu Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut Katayama Kazuhiro Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut Kawada Natsuko Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut Ikezawa Kenji Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut Fukutake Nobuyasu Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut Takakura Rena Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut Takano Yasuna Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut Tanaka Sachiko Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut Takenaka Akemi Department of Cytology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut Journal of Gastroenterology Springer Japan 46/5(2011-05-01), 657-663 0944-1174 46:5<657 2011 46 535 https://doi.org/10.1007/s00535-010-0343-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-010-0343-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Uehara Hiroyuki Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut NATIONALLICENCE 700 1- Ishikawa Osamu Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut NATIONALLICENCE 700 1- Katayama Kazuhiro Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut NATIONALLICENCE 700 1- Kawada Natsuko Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut NATIONALLICENCE 700 1- Ikezawa Kenji Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut NATIONALLICENCE 700 1- Fukutake Nobuyasu Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, 537-8511, Osaka, Japan aut NATIONALLICENCE 700 1- Takakura Rena Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut NATIONALLICENCE 700 1- Takano Yasuna Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut NATIONALLICENCE 700 1- Tanaka Sachiko Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut NATIONALLICENCE 700 1- Takenaka Akemi Department of Cytology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/5(2011-05-01), 657-663 0944-1174 46:5<657 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer