Branch duct intraductal papillary mucinous neoplasms in a retrospective series of 190 patients

Woo, Sang Myung; Ryu, Ji Kon; Lee, Sang Hyub; Yoon, Won Jae; Kim, Y. T.; Yoon, Yong Bum

doi:10.1002/bjs.6557

Cited by 87 publications

(48 citation statements)

References 45 publications

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“…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 increase14 …”

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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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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“…Furthermore, other studies have suggested that the consensus guidelines may over-select patients requiring resections. In 190 patients with BT-IPMN, the consensus guidelines would have inappropriately selected 54 patients for resection whereas in fact only 28 of these underwent surgery [11]. …”

Section: Surveillance Versus Resection In Low-risk Bt-ipmnsmentioning

confidence: 99%

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Garcea

Dennison

2011

Pancreatology

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“…Turk J Gastroenterol 2014; 25: 1-18 malignancy is around 25% (from 8% to 29-36%) (27,45,47,48). Cytological yield is poor with EUS-FNA: Cytology was positive in only 29% of malignant mucinous tumours.…”

Section: şEntürk H Management Of Cystic Diseases Of the Pancreasmentioning

confidence: 99%

“…In endoscopy, mucin protruding form papilla vateri is observed: the so-called "fishmouth" sign. While malignancy is found in 58% to 92% of main duct tumours, the rate is 6% to 46% in branch duct IPMN (47). As the age of the patient increases, the rate of malignancy increases as well.…”

Section: şEntürk H Management Of Cystic Diseases Of the Pancreasmentioning

confidence: 99%

Management of cystic diseases of the pancreas

Şentürk

2014

Turk J Gastroenterol

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Pancreatic cysts are challenging to the gastroenterologist. Detection rate is increasing and neither criteria for a definitive diagnosis, nor a validated surveillance strategy is available. Pancreatic endosonography with or without sampling is necessary in most of the cases. However this technique requires expertise and is not widely available. While some cysts have a malignant potential or already malign at the diagnosis, most are benign and remain so for decades. We are going to review the existing data on this controversial subject.

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Branch duct intraductal papillary mucinous neoplasms in a retrospective series of 190 patients

Abstract: A simple increase in cyst size is not a reliable predictor of malignancy. Observation is recommended for patients with a BD-IPMN smaller than 30 mm showing no suspicious features on imaging.

Cited by 87 publications

References 45 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

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Management of cystic diseases of the pancreas

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