Development and Validation of a Multi-institutional Preoperative Nomogram for Predicting Grade of Dysplasia in Intraductal Papillary Mucinous Neoplasms (IPMNs) of the Pancreas

Attiyeh, Marc A.; Castillo, Carlos Fernández‐del; Efishat, Mohammad Al; Eaton, Anne; Gönen, Mithat; Batts, Ruqayyah; Pergolini, Ilaria; Rezaee, Neda; Lillemoe, Keith D.; Ferrone, Cristina R.; Mino‐Kenudson, Mari; Weiss, Matthew J.; Cameron, John L.; Hruban, Ralph H.; D’Angelica, Michael I.; DeMatteo, Ronald P.; Kingham, T. Peter; Jarnagin, William R.; Wolfgang, Christopher L.; Allen, Peter J.

doi:10.1097/sla.0000000000002015

Cited by 112 publications

(142 citation statements)

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“…The prediction models were based on random forests (RF) and support vector machine (SVM) and were evaluated with tenfold cross‐validation. The features were also combined with clinical variables with known associations to risk …”

Section: Methodsmentioning

confidence: 99%

“…A total of 103 patients met the inclusion criteria. Grade of dysplasia found at resection was assessed by an expert pathologist as part of routine clinical care and categorized into low risk and high risk based on standard criteria . Among all patients, 27 were with high‐risk IPMN.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical variables were obtained from the database and by review of the electronic medical record. Five clinical variables: age at resection, cyst size, presence of solid component, presence of symptoms (abdominal pain or gastrointestinal disturbance), and gender — previously shown to be associated with IPMN risk — were included in our prediction model. In general, older symptomatic men with larger cysts and presence of solid component are at higher risk for invasive cancer.…”

Section: Methodsmentioning

confidence: 99%

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CT radiomics to predict high‐risk intraductal papillary mucinous neoplasms of the pancreas

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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CT radiomics to predict high‐risk intraductal papillary mucinous neoplasms of the pancreas

et al. 2018

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“…Risk factors for progression of IPMNs into PDAC include main duct-type, larger cyst size (> 3 cm), pancreatobiliary or intestinal type, and presence of solid components or mural nodules and symptoms of pain and weight loss [60]. Careful gross and microscopic examinations with extensive tissue sampling are required for accurate diagnosis and appropriate management of IPMN patients.…”

Section: Ipmnmentioning

confidence: 99%

Precursor Lesions of Pancreatic Cancer

Kim

Hong

2018

Oncol Res Treat

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Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer death. Although the treatment modalities are improving, the prognosis of PDAC continues to be poor. Therefore, early detection of PDAC or its precursor lesions may be the best way to improve patient survival. PDACs have several different precursor lesions, including pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), intraductal tubulopapillary neoplasms (ITPNs), intraductal oncocytic papillary neoplasms (IOPNs), and mucinous cystic neoplasms (MCNs). PanINs cannot be identified using imaging modalities, while the other lesions are radiologically detectable. These precursor lesions are categorized based on structural and cytological atypia as low-grade and high-grade lesions. We discuss recent updates regarding histopathological and molecular pathological overviews of PDAC precursor lesions. Better understanding of such lesions may contribute to earlier detection of PDAC or its precursor lesions and improve PDAC patient survival.

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“…Furthermore, diabetes mellitus in IPMN patients has recently been found to be associated with high-grade dysplasia as well as invasive cancer and may therefore be regarded as an additional worrisome feature [14]. Other factors that have been discovered to be associated with malignancy but have not (yet) found their way into the current guidelines are pain symptoms, weight loss, and elevated serum carcinoembryonic antigen [15,16]. …”

Section: Observation Versus Operation - When?mentioning

confidence: 99%

Surgery of Cystic Tumors of the Pancreas - Why, When, and How

D’Haese¹,

Werner²

2018

Visc Med

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The management of cystic pancreatic neoplasms has increasingly gained clinical attention due to their frequent incidental detection by cross-sectional imaging and their potential for progression to pancreatic cancer. Surgical resection is warranted for all mucinous cystic neoplasms, solid pseudopapillary neoplasms, and main-duct intraductal papillary mucinous neoplasms since these lesions harbor a major risk for malignant transformation. For branch-duct IPMN (BD-IPMN), the risk for malignancy is considerably lower so that some lesions may be safely followed while others require surgical resection. The clinical challenge lies in making the correct preoperative diagnosis and estimation of the risk of malignancy in BD-IPMN. Therefore, the existing evidence and current guidelines on the management of cystic lesions of the pancreas are summarized and controversially discussed from a surgical point of view.

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Development and Validation of a Multi-institutional Preoperative Nomogram for Predicting Grade of Dysplasia in Intraductal Papillary Mucinous Neoplasms (IPMNs) of the Pancreas

Abstract: For patients with suspected IPMNs, we present an independently validated model for the prediction of high-risk disease.

Cited by 112 publications

References 20 publications

CT radiomics to predict high‐risk intraductal papillary mucinous neoplasms of the pancreas

CT radiomics to predict high‐risk intraductal papillary mucinous neoplasms of the pancreas

Precursor Lesions of Pancreatic Cancer

Surgery of Cystic Tumors of the Pancreas - Why, When, and How

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