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dc.contributor.advisorTaylor S. Riallen_US
dc.creatorAdvitya Malhotraen_US
dc.date.accessioned2011-12-20T16:05:00Z
dc.date.available2010-09-28en_US
dc.date.available2011-12-20T16:05:00Z
dc.date.created2009-07-20en_US
dc.date.issued2009-04-27en_US
dc.identifier.otheretd-07202009-133501en_US
dc.identifier.urihttp://hdl.handle.net/2152.3/173
dc.description.abstractIntraductal papillary neoplasm (IPMN) is an uncommon cancer of the pancreas, histologically characterized as a distinct entity by WHO in 1996, as noninvasive (adenoma, borderline neoplasm, carcinoma in situ) or invasive. Our understanding of this disease comes mainly from small retrospective reports and anecdotal experience. While it is clear that patients with benign IPMNs do better than patients with invasive IPMNs and adenocarcinoma, it is not clear if, once invasive, IPMNs have a more favorable prognosis than adenocarcinoma not associated with IPMNs. Our goal was to evaluate a large population-based cohort of patients with invasive IPMN and compare their demographic factors and outcomes to those of patients with pancreatic adenocarcinoma (PA). Using the Surveillance, Epidemiology, and End Results (SEER) database (1988 to 2003), we identified all patients with invasive IPMN or PA. A total of 2,166 patients with invasive IPMN and 35,515 with PA were identified. Patients with IPMN were younger than patients with PA at the time of diagnosis (67.0 vs. 70.1, P<.0001). The overall 5-year survival was 8.8% for IPMN (median, 5 months) and 3.7% for PA (median, 4 months, P < .0001). Patients with unresected IPMN had a 5-year survival rate of 4.2% compared to 2.2% in patients with unresected PA (P < .0001). Surgical resection was a significant independent predictor of improved survival, as was female gender, race other than white and black, married status and negative lymph nodes. We conclude, IPMN is a more indolent disease than PA. Patients with IPMN tend to present at a younger age, are more likely to have resectable disease, and are much more likely to undergo potentially curative resection. The long-term survival for patients with IPMN is significantly better when compared to the long-term survival of patients with PA.en_US
dc.format.mediumelectronicen_US
dc.language.isoengen_US
dc.rightsCopyright © is held by the author. Presentation of this material on the TDL web site by The University of Texas Medical Branch at Galveston was made possible under a limited license grant from the author who has retained all copyrights in the works.en_US
dc.subjectpancreatic canceren_US
dc.subjectintraductal papillary mucinous neoplasmen_US
dc.subjectepidemiologyen_US
dc.titleDescriptive epidemiology and outcome of patients with intraductal papillary mucinous neoplasm (IPMN): a population-based comparison to pancreatic adenocarcinoma and review of literature.en_US
dc.type.materialtexten_US
dc.type.genrethesisen_US
thesis.degree.nameMaster of Scienceen_US
thesis.degree.levelMasteren_US
thesis.degree.grantorThe University of Texas Medical Branchen_US
thesis.degree.departmentPublic Healthen_US
dc.contributor.committeeMemberKaren E. Szauteren_US
dc.contributor.committeeMemberDon W. Powellen_US


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