478 Background: Invasive pancreatic carcinoma associated with intraductal papillary mucinous neoplasms (IC-IPMN) has showed more favorable prognosis than invasive pancreatic ductal carcinoma (IPDC) following surgical resection in some studies. IC-IPMN differs from IPDC in clinical manifestation and biology profile and is mostly surgically resectable in initial presentation. Chemotherapeutic effect on unresectable IC-IPMN is not described in the literature yet. Methods: Our pancreatic cancer database was reviewed to identify 43 patients with IC-IPMN between 2006-2013. IC-IPMN was determined with surgical pathology or with radiological diagnosis and biopsy evidence of adenocarcinoma. Of 43 patients, 14 unresectable IC-IPMN patients received GEM as first-line chemotherapy regimen. We investigated GEM efficacy, Overall Survival (OS), Progression Free Survival (PFS) and 1-year survival rate. Results: Characteristic baseline included gender (male: 9, female: 5), age (median: 73 years old), ECOG performance status (0-1, 92%), location (head 7, body/tail 6, diffuse 1), prior surgical resection (8), biliary intervention (5), metastasis (11), CRP (median: 0.15mg/dl, 0.1-1.0), CA19-9 (median: 29U/ml, 8-20820), CEA (median: 3.1ng/ml, 0.1-237). Median OS, PFS and 1-year survival rate were 24.0 months, 8.0 months and 86%. Gemcitabine therapy demonstrated 14% (2/14) response rate and 79% (11/14) disease control rate. Conclusions: UnresectableIC-IPMN indicates favorable survival and fair response to GEM in our study. Limitations are retrospective study at single center and small population due to its disease rarity.
Clinical implications of the molecular characterization of intraductal papillary mucinous neoplasms of the pancreas
