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Oct 2012

The “Malignant Truth” About the Recurrence of Pancreatic Intraductal Papillary Mucinous Neoplasms—Reply

Author Affiliations

Author Affiliations: First Department of Surgery, Yamagata University, Japan (Dr Moriya); and Center for Pancreatic Disease, Boise, Idaho (Dr Traverso).

Arch Surg. 2012;147(10):977-980. doi:10.1001/archsurg.2012.2312

In reply

A letter to the editor regarding any published article is always welcome and is usually constructive criticism or the result of a failure on the part of the original authors to relay their findings in a clear fashion. The end result is a clarification of the data to avoid misunderstanding and to make clear the implications. The letter by Frampton et al has given us an opportunity for clarification.

They questioned why we chose to compare 2 groups: benign (adenoma and borderline dysplasia) vs malignant (carcinoma in situ and invasive adenocarcinoma). In our previous review study,1 we had found the comparison of benign vs malignant useful for the following reason. The average age of the patients from these 2 groups was significantly different upon diagnosis. From these 2 groups, we could best observe a significant difference of about 5 years from the younger average age of the benign cases vs the older average age of malignant cases. The time of progression for the adenoma-carcinoma sequence was best estimated with the comparison of benign vs malignant rather than with other comparisons such as noninvasive vs invasive intraductal papillary mucinous neoplasm (IPMN).

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