Validation of international consensus guidelines for the resection of branch duct-type intraductal papillary mucinous neoplasms

Jang, Jin–Young; Park, Tansol; Lee, S.; Kang, Mee Joo; Lee, S. Y.; Lee, K. B.; Chang, Young Soo; Kim, S.-W.

doi:10.1002/bjs.9491

Cited by 125 publications

(106 citation statements)

References 20 publications

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“…Based on their results, cyst size was not even related with malignant progression. Similarly, a recent study (92) that also analyzed a BD-IPMN surgical cohort showed the presence of mural nodules and MD dilation as the best predictors of malignancy. Cyst size greater than 3 cm seems to be the most debatable risk factor with some studies (93) supporting its role as an independent predictor of malignancy and other publications (44) recommending a conservative approach with close surveillance if present alone without other "worrisome features".…”

Section: Current Guidelines and Recommendationsmentioning

confidence: 67%

Intraductal papillary mucinous neoplasms and mucinous cystadenomas: current status and recommendations

Moris

Wallace

2017

Rev Esp Enferm Dig

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The real prevalence of pancreatic cystic lesions remains unknown. The malignant potential of some of these lesions remains a cause for significant concern. Thus, it is mandatory to develop a strategy to clearly discriminate those cysts with a potential for malignant transformation from those that do not carry any significant risk. Intraductal papillary mucinous neoplasms and mucinous cystadenomas are mucinous cystic neoplasms with a known malignant potential that have gained greater recognition in recent years. However, despite the numerous studies that have been carried out, their differential diagnosis among other cysts subtypes and their therapeutic approach continue to be a challenge for clinicians. This review contains a critical approach of the current recommendations and management strategies regarding intraductal papillary mucinous neoplasms and mucinous cystadenomas, as well as highlighting the limitations exposed in current guidelines.

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Section: Current Guidelines and Recommendationsmentioning

confidence: 67%

Intraductal papillary mucinous neoplasms and mucinous cystadenomas: current status and recommendations

Moris

Wallace

2017

Rev Esp Enferm Dig

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“…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

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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.

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“…15 Many studies have distinguished the imaging findings of malignant BDIPMNs. 8,13,16,17 In contrast, few studies of the imaging findings of malignant MD-IPMNs have been published 14,18,19 because surgical resection has been recommended for all MD-IPMNs. However, recent studies suggested nonoperative management of MD-IPMNs in selected patients with lower risk because the natural history of MDIPMNs can be variable.…”

mentioning

confidence: 87%

Validation of the 2012 International Consensus Guidelines Using Computed Tomography and Magnetic Resonance Imaging

et al. 2016

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Validation of international consensus guidelines for the resection of branch duct-type intraductal papillary mucinous neoplasms

Cited by 125 publications

References 20 publications

Intraductal papillary mucinous neoplasms and mucinous cystadenomas: current status and recommendations

Intraductal papillary mucinous neoplasms and mucinous cystadenomas: current status and recommendations

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

Validation of the 2012 International Consensus Guidelines Using Computed Tomography and Magnetic Resonance Imaging

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