Rapid Growth Rates of Suspected Pancreatic Cyst Branch Duct Intraductal Papillary Mucinous Neoplasms Predict Malignancy

Kwong, Wilson; Lawson, Robert D.; Hunt, Gordon C.; Fehmi, Syed M. Abbas; Proudfoot, James; Xu, Ronghui; Giap, Andrew Q.; Tang, Raymond; Gonzalez, Ingrid; Krinsky, Mary Lee; Savides, Thomas J.

doi:10.1007/s10620-015-3679-8

Cited by 79 publications

(52 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1). Of these studies, 33 investigated mural nodules5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 21 examined dilatation of the main pancreatic duct (MPD)7 9, 15 16, 18 21, 23 26, 27 30, 32 36, 38, 39, 40, 41, 42, 43, 44, 45, 46, 21 analysed cyst size5 7, 8, 9 14, 15 18, 20 23, 25 27, 28 31, 36 38, 40 41, 43 47, 48, 49, 17 assessed CA19‐9 increase…”

Section: Resultsmentioning

confidence: 99%

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

et al. 2018

View full text Add to dashboard Cite

BackgroundEstimation of the risk of malignancy in intraductal papillary mucinous neoplasia (IPMN) of the pancreas is a clinical challenge. Several routinely used clinical factors form the basis of the current consensus guidelines. This study aimed to determine the predictive values of the most commonly assessed risk factors.MethodsA meta‐analysis of individual risk factors of malignancy in IPMN was performed. Contingency tables were derived from these data, and sensitivity, specificity, negative and positive predictive values, and diagnostic odds ratios (DOR) were determined. Hierarchical summary receiver operating characteristic (HSROC) curves for each factor were calculated and the respective area under the curve (AUC) was assessed.ResultsA total of 3443 studies were screened initially. Analysis of recent literature revealed 60 studies with 13 relevant risk factors including clinical, serological and radiological parameters. The largest area under the HSROC curve was found for weight loss (0·84) and jaundice/raised bilirubin level (0·80), followed by increased carcinoembryonic antigen (CEA) (0·79) or carbohydrate antigen (CA) 19‐9 (0·78) levels. The most sensitive factors were patient age (71 per cent) and mural nodules (65 per cent), and jaundice/raised bilirubin level (97 per cent) and increased CEA level (95 per cent) were most specific. None of the analysed factors reached a positive or negative level of prediction beyond 90 per cent.ConclusionNone of the established criteria safely distinguishes malignant from non‐malignant lesions.

show abstract

Section: Resultsmentioning

confidence: 99%

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Rapidly growing cysts have been shown to harbor a greater risk of malignancy. 26,27 Because the absolute value of each median growth rate was lower than the growth rate predictive of malignant transformation (2-11.3 mm/y), 26-28 these differences likely do not have strong clinical implications. Although these rates of progression do not suggest greater malignant transformation in the short-term, whether the faster growth rate translates into a greater risk of malignancy in the long-term is unknown.…”

Section: Discussionmentioning

confidence: 99%

Progression of Incidental Intraductal Papillary Mucinous Neoplasms of the Pancreas in Liver Transplant Recipients

et al. 2016

View full text Add to dashboard Cite

show abstract

“…They are classified based on their grade of dysplasia (low, moderate, and high-grade dysplasia) or on the extent of ductal involvement (side branch (SB), main duct (MD), or mixed type). Main duct involvement contains a high risk for malignant transformation (5-year risk for high-grade dysplasia of 63% compared with 15–24% for SB-IPMN) [68,69]. Other high-risk stigmata include an enhanced solid component and a main duct larger than 10 mm [70].…”

Section: What Should Be Detected During Surveillance?mentioning

confidence: 99%

Surveillance for neoplasia in the pancreas

Overbeek

Cahen

Canto

et al. 2016

Best Practice & Research Clinical Gastroenterology

View full text Add to dashboard Cite

Despite its low incidence in the general population, pancreatic cancer is one of the leading causes of cancer-related mortality. Survival greatly depends on operability, but most patients present with unresectable disease. Therefore, there is great interest in the early detection of pancreatic cancer and its precursor lesions by surveillance. Worldwide, several programs have been initiated for individuals at high risk for pancreatic cancer. Their first results suggest that surveillance in high-risk individuals is feasible, but their effectiveness in decreasing mortality remains to be proven. This review will discuss which individuals are eligible for surveillance, which lesions are aimed to be detected, and which surveillance modalities are being used in current clinical practice. Furthermore, it addresses the management of abnormalities found during surveillance and topics for future research.

show abstract

Rapid Growth Rates of Suspected Pancreatic Cyst Branch Duct Intraductal Papillary Mucinous Neoplasms Predict Malignancy

Abstract: BD-IPMN growth rates ≥2 mm/year and total growth of ≥10 mm should be considered worrisome features for BD-IPMN at increased risk of malignancy.

Cited by 79 publications

References 9 publications

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

Progression of Incidental Intraductal Papillary Mucinous Neoplasms of the Pancreas in Liver Transplant Recipients

Surveillance for neoplasia in the pancreas

Contact Info

Product

Resources

About