Clinical and pathologic correlation of 84 mucinous XXXX of the pancreas: can one reliably differentiate benign from malignant (or premalignant) @entity5 ?

@entity1 @entity1124 @entity5 @entity4347 @entity8940 @entity14775 @entity9296 @entity420 @entity7157
OBJECTIVE: To determine whether the long-term behavior of @entity14775 of the pancreas could be predicted using a novel, precisely defined classification of benign @entity8940 , noninvasive @entity14775 , and invasive @entity4347 . The primary interest was to obtain long-term follow-up after complete resection to determine the recurrence rates based on this objective classification. BACKGROUND: Current understanding is that all @entity14775 of the pancreas are potentially malignant and that @entity8940 , when completely removed, are biologically benign. @entity7157 are thought to be less aggressively malignant than @entity420 , but reported recurrence rates vary widely and are unpredictable. METHODS: All @entity1 who underwent "curative" resection for @entity14775 at Mayo Clinic Rochester from 1940 to 1997 were identified. All available pathology slides, gross specimens, and clinical records were reviewed, eliminating @entity1 with inadequate documentation. @entity5 were reclassified as @entity8940 , noninvasive proliferative mucinous @entity5 , or invasive @entity7157 based on specific histologic criteria. RESULTS: Of 84 @entity1 (70 @entity1 , 14 @entity1 ) with @entity14775 of the pancreas, 54 were classified as @entity9296 , 23 as noninvasive @entity14775 , and only 7 as @entity7157 . Recurrent disease developed in none of the 77 @entity1 without invasion, but 5 of the 6 @entity1 surviving resection for @entity7157 died of recurrent @entity7157 within 5 years. CONCLUSIONS: When the @entity5 is completely resected and subjected to adequate histopathologic examination based on these objective criteria, absence of tissue invasion predicts a curative operation and detailed follow-up may be unnecessary. In contrast, a histologic diagnosis of invasive @entity7157 portends a dismal prognosis, similar to that of typical @entity1124 .
