Evaluation of the Prognostic Significance of 'High-risk Stigmata' in the International Consensus Guidelines 2012 for Intraductal Papillary Mucinous Neoplasm

Study Background: In the International Consensus Guidelines 2012 for intraductal papillary mucinous neoplasm (IPMN), 'high-risk stigmata' (HRS) were described as indications for resection. The purpose of this study was to evaluate the prognostic meaning of HRS in the 2012 guidelines. Method: Clinical and pathological data from 98 patients who underwent pancreatic resection for IPMN at our institution between 1994 and 2014 were retrospectively analyzed. Results: The 98 resected IPMNs were categorized as demonstrating no criteria (NC) (n=18), worrisome features (WF) (n=39), or HRS (n=46) according to the guidelines. By multivariate analysis, positive lymph node metastasis and HRS were significantly identified as independent prognostic factors. Five-year disease-specific survival rates for NC and WF were both 100%, whereas that for HRS was significantly poorer at 49.5% (p