Risk factors associated with the postoperative recurrence of intraductal papillary mucinous neoplasms of the pancreas.

Objectives: The risk factors correlated with the post-operative recurrence of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are not well established. The aim was to determine the risk factors of recurrence. Methods: We reviewed retrospectively the differences of clinicopathologic features between the recurrence and nonrecurrence groups of patients with IPMN who underwent surgical resection and analyzed the recurrence-related factors. Results: A total of 103 patients were confirmed to have IPMNs. The mean postoperative follow-up was 3.2 years, and the recurrence rate was 12.6%. Recurrent cases (n = 13) had the following pathologic grades: adenoma, 1; and invasive carcinoma, 12. The mean postoperative survival was 17.0 months in the recurrence group and 41.4 months in the nonrecurrence group (P G 0.001). The independent risk factors of recurrence were invasive carcinoma (P = 0.017, hazard ratio = 71.79; 95% confidence interval (CI) = 2.13Y2417.05), elevated carbohydrate antigen 19-9 (P = 0.007, hazard ratio = 37.97, 95% CI = 2.66Y542.32), and main location in the pancreatic head (P = 0.038, hazard ratio = 0.16, 95% CI = 0.03Y0.90). Conclusions: The risk factors associated with recurrence of IPMNs were invasive pathology, elevated carbohydrate antigen 19-9, and main location in the pancreatic head. A more careful follow-up is needed for such patients.