{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1050870696492931328.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"HDL","@value":"http://hdl.handle.net/10458/0002002419"}},{"identifier":{"@type":"URI","@value":"https://miyazaki-u.repo.nii.ac.jp/records/2002419"}}],"resourceType":"学術雑誌論文(journal article)","dc:title":[{"@language":"en","@value":"Postoperative Outcomes and Strategic Refinement in Intraductal Papillary Mucinous Neoplasm Management: A Single Academic Cancer Center Experience"}],"dc:language":"en","description":[{"type":"Abstract","notation":[{"@language":"en","@value":"Background/Aim\nIntraductal papillary mucinous neoplasm (IPMN) of the pancreas is a precursor lesion with variable malignant potential. Due to its heterogeneity, optimal treatment strategies remain controversial, especially regarding surgical resection and surveillance indications. We reviewed our institutional outcomes to reassess the current postoperative strategy and refine management guidelines.\nPatients and Methods\nThis study retrospectively and consecutively analyzed the data of 49 IPMN patients who underwent pancreatectomy at an academic institution from 2015 to May 2025.\nResults\nDiagnostic mismatch between preoperative and final pathological findings was observed in 39% of cases, with overdiagnosis (downgrade group) being more common than underdiagnosis. Overdiagnosed cases were significantly associated with main pancreatic duct dilation (>5 mm) (p=0.012) and elevated amylase levels (p=0.031), while the only upgraded case involved invasive carcinoma with mural nodule and Sonazoid enhancement. Histological grade strongly influenced prognosis: Patients with adenoma or carcinoma in situ showed favorable outcomes (5-year OS ≥89%), whereas those with invasive IPMN had markedly worse survival (5-year OS 36%; p<0.001). Elevated CA19-9 was a significant negative prognostic factor (p=0.031), while lymph node metastasis (p=0.035) and advanced tumor stage (p=0.0014) were also associated with poor outcomes. Tumors located in the pancreatic tail and those classified as mixed-type IPMN tended to have inferior survival, though without statistical significance. Cancer recurrence occurred in 18% of patients, primarily via peritoneal and hepatic routes.\nConclusion\nPreoperative diagnostic inaccuracies remain common in IPMN, and invasive transformation, elevated CA19-9, lymph node metastasis, and tumor stage are key prognostic factors. A multimodal diagnostic approach is needed to improve risk stratification and guide appropriate surgical management."}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1070870696492931330","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"七島, 篤志"},{"@language":"ja-Kana","@value":"ナナシマ, アツシ"},{"@language":"en","@value":"Nanashima, Atsushi"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931334","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"今村, 直哉"},{"@language":"ja-Kana","@value":"イマムラ, ナオヤ"},{"@language":"en","@value":"Imamura, Naoya"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931335","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Hiyoshi, Masahide"}],"jpcoar:affiliationName":[{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931332","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"土持, 有貴"},{"@language":"ja-Kana","@value":"ツチモチ, ユウキ"},{"@language":"en","@value":"Tsuchimochi, Yuki"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931328","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"和田, 敬"},{"@language":"ja-Kana","@value":"ワダ, タカシ"},{"@language":"en","@value":"Wada, Takashi"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931333","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Hamada, Takeomi"},{"@language":"ja-Kana","@value":"ハマダ, タケオミ"},{"@language":"ja","@value":"濵田, 剛臣"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931329","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Suzuki, Yasuyuki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931336","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Araki, Yuusuke"}],"jpcoar:affiliationName":[{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931331","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"細川, 歩"},{"@language":"ja-Kana","@value":"ホソカワ, アユム"},{"@language":"en","@value":"Hosokawa, Ayumu"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]},{"@id":"https://cir.nii.ac.jp/crid/1070870696492931337","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"河上, 洋"},{"@language":"ja-Kana","@value":"カワカミ, ヒロシ"},{"@language":"en","@value":"Kawakami, Hiroshi"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"宮崎大学"},{"@language":"en","@value":"University of Miyazaki"}]}],"publication":{"publicationIdentifier":[{"@type":"EISSN","@value":"27327787"}],"prism:publicationName":[{"@language":"en","@value":"Cancer diagnosis & prognosis"}],"dc:publisher":[{"@value":"International Institute of Anticancer Research"}],"prism:publicationDate":"2026","prism:volume":"6","prism:number":"2","prism:startingPage":"291","prism:endingPage":"302"},"dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","dc:rights":["©2026 The Author(s). Anticancer Research is published by the International Institute of Anticancer Research."],"url":[{"@id":"https://miyazaki-u.repo.nii.ac.jp/records/2002419"}],"foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Intraductal%20papillary%20mucinous%20neoplasm%20(IPMN)","dc:title":"Intraductal papillary mucinous neoplasm (IPMN)"},{"@id":"https://cir.nii.ac.jp/all?q=malignant%20potential","dc:title":"malignant potential"},{"@id":"https://cir.nii.ac.jp/all?q=pancreatectomy","dc:title":"pancreatectomy"},{"@id":"https://cir.nii.ac.jp/all?q=postoperative%20outcomes","dc:title":"postoperative outcomes"},{"@id":"https://cir.nii.ac.jp/all?q=surveillance%20strategy","dc:title":"surveillance strategy"}],"dcterms:subject":[{"subjectScheme":"Other","notation":[{"@language":"en","@value":"Intraductal papillary mucinous neoplasm (IPMN)"}]},{"subjectScheme":"Other","notation":[{"@language":"en","@value":"malignant potential"}]},{"subjectScheme":"Other","notation":[{"@language":"en","@value":"pancreatectomy"}]},{"subjectScheme":"Other","notation":[{"@language":"en","@value":"postoperative outcomes"}]},{"subjectScheme":"Other","notation":[{"@language":"en","@value":"surveillance strategy"}]}],"dataSourceIdentifier":[{"@type":"IRDB","@value":"oai:irdb.nii.ac.jp:00851:0007318503"}]}