Comparison of the Sendai and Fukuoka Consensus Guidelines for the Management of Mucinous Cystic Lesions of the Pancreas: Are We Making Progress?

Abbott, Daniel E.; Ahmad, Syed A.

doi:10.1245/s10434-014-3502-3

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…They were the first international consensus guidelines for the management of patients with mucinous PCLs. 17 They recommended surgical resection for all presumed main duct or mixed (main and branch) duct IPMNs and all MCNs. For presumed branch duct IPMNs, the Sendai guidelines recommend serial imaging for cysts up to 3 cm and surgical resection for cysts greater than 3 cm.…”

Section: Guidelinesmentioning

confidence: 99%

“…In 2004 at the 11th Congress of the International Association of Pancreatology (IAP) in Sendai, Japan, the Sendai Guidelines were developed and subsequently published in 2006. They were the first international consensus guidelines for the management of patients with mucinous PCLs 17 . They recommended surgical resection for all presumed main duct or mixed (main and branch) duct IPMNs and all MCNs.…”

Section: Guidelinesmentioning

confidence: 99%

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Diagnostic approaches for pancreatic cystic lesions

Kanani

Isherwood

Chung

et al. 2020

ANZ Journal of Surgery

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Background: Cystic lesions of the pancreas (PCLs) may be inflammatory or proliferative and making an accurate and timely pre-operative diagnosis remains a significant clinical challenge. This is principally due to the heterogeneity of the pathological processes involved. PCLs constitute an entity with diverse histology and although infrequent, the possible potential for malignant transformation of these lesions and the opportunity for curative surgery mandates that our diagnostic approaches are up to date and evidence based. In addition, improved diagnostic accuracy is crucial to prevent unnecessary surgical procedures with the inevitable associated morbidity. Methods: This narrative review examines the current diagnostic benchmarks and identifies novel diagnostic techniques that warrant further consideration, a number of which are beginning to be included in routine clinical practice when these PCLs are being investigated. A computerized search was made of MEDLINE, EMBASE and PubMed using the search words 'diagnostic approaches to pancreatic cystic lesions'. All relevant articles in English language or with an English abstract were retrieved and additionally cross referenced. Conclusion: The increasing accuracy of available imaging techniques together with the wider availability of endoluminal ultrasound and the development of additional novel methods to assess PCLs presents an opportunity to significantly improve the pre-operative diagnosis rate. This is essential to classify the type of PCL and hence guide the management particularly with lesions where there is a likelihood of progression to more serious pathology. We have highlighted the need for a comprehensive and standardized algorithm for the diagnosis and management of PCLs.

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Section: Guidelinesmentioning

confidence: 99%

Section: Guidelinesmentioning

confidence: 99%

Diagnostic approaches for pancreatic cystic lesions

Kanani

Isherwood

Chung

et al. 2020

ANZ Journal of Surgery

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“…The Sendai consensus guidelines and subsequent updated Fukuoka consensus guidelines have been widely adopted as an algorithm to direct the treatment strategies for mucinous PCN patients [ 2 , 3 ]. The high-risk parameters for malignancy in the guidelines were verified by several retrospective studies, but the outcomes have been controversial [ 4 , 5 ]. Some articles reported that many mucinous PCNs did not meet these criteria and were still proven to harbor high-grade dysplasia or even invasive cancers, and the validity of the guidelines were doubtful [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The value of systemic inflammatory markers in identifying malignancy in mucinous pancreatic cystic neoplasms

et al. 2017

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The treatment decision-making of mucinous pancreatic cystic neoplasm (PCN) has become a common clinical problem since the diagnostic accuracy of current tests in identifying malignancies in pancreatic cysts is limited. In this study, we aimed to validate the predictive value of systemic inflammatory factors in detecting malignant PCNs. Two hundred and forty-five patients with pathologically confirmed mucinous PCNs in a single Chinese institution were retrospectively analyzed. Receiver operating characteristic (ROC) curves were calculated to determine the optimal cut-off values and measure the diagnostic value. The results showed that neutrophil count (P = 0.009), lymphocyte count (P = 0.002), neutrophil-to-lymphocyte ratio (NLR, P < 0.001), platelet-to-lymphocyte ratio (PLR, P < 0.001) and lymphocyte-to-monocyte ratio (LMR, P < 0.001) were distributed differently among the various differentiation groups of PCN. The univariate analyses indicated that a neutrophil count ≥ 2.8 × 109/L (P = 0.024), lymphocyte count ≤ 1.9 × 109/L (P < 0.001), PLR ≥ 125 (P < 0.001), NLR ≥ 1.96 (P < 0.001), and LMR ≤ 4.29 (P < 0.001) were significantly associated with invasive carcinomas in PCN patients. In addition, the multivariate analyses demonstrated that PLR ≥ 125 and LMR ≤ 4.29 were independent predictors of invasive malignancies. The ROC curves exhibited the malignant detection utility of the independent factor-based predictive model with an area under the curve (AUC) of 0.858 (P < 0.001). In conclusion, systemic inflammatory markers provide a supportive and easily accessible tool for the preoperative diagnoses of malignant PCNs.

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“…The most crucial change in the updated guidelines was a shift of cyst size ≥3 cm from “ high‐risk stigmata ” to “ worrisome ,” requiring a follow‐up assessment by endoscopic ultrasound (EUS) or regular surveillance in the absence of other risk features. However, the controversy regarding the correlation between cyst size and AN remains and the safety and validity of both guidelines remain debatable …”

Section: Introductionmentioning

confidence: 99%