Observational studyAnnals of surgery2018
Does Surgical Margin Impact Recurrence in Noninvasive Intraductal Papillary Mucinous Neoplasms?: A Multi-institutional Study.
Observational study in Annals of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 32 citations in OpenAlex.
- Global research trends in robotic surgery for rectal cancer: a bibliometric and science-mapping analysis.Journal of robotic surgery · 2026Review
- Informing Decision-making for Transected Margin Reresection in Intraductal Papillary Mucinous Neoplasm-derived Pancreatic Cancer: An International Multicenter Study.Annals of surgery · 2026Article
- Important radiological and clinicopathological risk factors for the recurrence of intraductal papillary mucinous neoplasms after surgical resection.European radiology · 2025Article
- Middle segment preserving pancreatectomy versus total pancreatectomy: a comparative analysis of short- and long-term outcomes.Surgery today · 2025Article
- Diagnostic and therapeutic guidelines for pancreatic cystic tumors: recommendations of Polish Pancreatic Club experts.Przeglad gastroenterologiczny · 2025Article
- Recurrence following Resection of Intraductal Papillary Mucinous Neoplasms: A Systematic Review to Guide Surveillance.Journal of clinical medicine · 2024Review
- Accuracy of models to prognosticate survival after surgery for pancreatic cancer in the era of neoadjuvant therapy.Journal of surgical oncology · 2023Article
- A Growing Armamentarium for the Robotic Pancreas Surgeon?Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Increased cost burden associated with robot-assisted rectopexy: do patient outcomes justify increased expenditure?Surgical endoscopy · 2023Article
- Landmark Series: Importance of Pancreatic Resection Margins.Annals of surgical oncology · 2022Article
- Pathology of intraductal papillary mucinous neoplasms.Langenbeck's archives of surgery · 2021Review
- Article
- Metachronous intraductal papillary mucinous neoplasms disseminate via the pancreatic duct following resection.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2020Article
- Surgical strategy for intraductal papillary mucinous neoplasms of the pancreas.Surgery today · 2020Review
- Recurrence patterns after surgical resection of intraductal papillary mucinous neoplasm (IPMN) of the pancreas; a multicenter, retrospective study of 1074 IPMN patients by the Japan Pancreas Society.Journal of gastroenterology · 2020Observational
- Pancreatic cystic lesions: risk stratification and management based on recent guidelines.Frontline gastroenterology · 2019Article
- Diagnosis and management of intraductal papillary mucinous neoplasms of the pancreas.Acta bio-medica : Atenei Parmensis · 2018Review
Corrections and comments
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Authors and funding
21 authors at 8 institutions in 1 country.
Funding
Abstract
objectiveThe relevance of margin positivity on recurrence after resection of intraductal papillary mucinous neoplasms (IPMNs) is poorly defined and represents one reason controversy remains regarding optimal surveillance recommendations.
methodsPatients undergoing surgery for noninvasive IPMN at 8 academic medical centers from the Central Pancreas Consortium were analyzed. A positive margin was defined as presence of IPMN or pancreatic intraepithelial neoplasia.
resultsFive hundred two patients underwent surgery for IPMN; 330 (66%) did not have invasive cancer on final pathology and form the study cohort. Of these, 20% harbored high grade dysplasia. A positive margin was found in 20% of cases and was associated with multifocal disease (P = 0.02). The majority of positive margins were associated with low grade dysplasia. At a median follow-up of 36 months, 34 (10.3%) patients recurred, with 6.7% developing recurrent cystic disease and 3.6% developing invasive cancer. On multivariate analysis, margin positivity was not associated with recurrence of either IPMN or invasive cancer (P > 0.05). No association between margin status and development of recurrence at the margin was found. Only 6% of recurrences developed at the resection margin and median time to recurrence was 22 months. Of note, 18% of recurrences occurred > 5 years following surgery.
conclusionMargin positivity after resection for noninvasive IPMNs is primarily due to low grade dysplasia and is not associated with developing recurrence in the remnant pancreas or at the resection margin. Long-term surveillance is required for all patients, as a significant number of recurrences developed over 5 years after the index operation.
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