International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas

Tanaka, Masao; Castillo, C. Fernandez-del; Adsay, Volkan; Chari, Suresh T.; Falconi, Massimo; Jang, Jin Young; Kimura, Wataru; Lévy, Philippe; Pitman, Martha B.; Schmidt, C. Max; Shimizu, Michio; Wolfgang, Christopher L.; Yamaguchi, Koji; Yamao, Kenji

doi:10.1016/j.pan.2012.04.004

Cited by 2,102 publications

(2,456 citation statements)

References 180 publications

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“…Although the dogma that all MD IPMN should be resected is based on an estimated malignancy rate of 61·6 per cent, compared with only 25·5 per cent for BD IPMN2, IPMN with only minimal MD involvement can be followed up safely without surgical intervention in some patients65. On the other hand, BD IPMN with high‐risk signs according to the Fukuoka consensus should be resected2. Future biomarkers might provide safe exclusion of malignancy in MD and BD IPMN.…”

Section: Discussionmentioning

confidence: 99%

“…The major reason is the absence of factors that clearly predict malignancy. To overcome this issue, consensus conferences in Sendai1 and Fukuoka2 have defined combinations of risk factors that may predict malignancy more sensitively and specifically. A large number of mainly single‐centre analyses based on these criteria have been published, but a recent meta‐analysis3 of data from these publications demonstrated that both overall sensitivity and specificity of the most recent (Fukuoka) criteria were relatively low.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…The remaining three guidelines (#5, #7, #9) are the current comprehensive guidelines citing diagnostic work‐up, indications for surgery, surveillance after surgery, and surveillance of non‐resected IPMN 11, 12, 13. In this section, we compare these three guidelines (Table 2).…”

Section: Comparison Of Current Guidelines For Ipmnmentioning

confidence: 99%

“…Although several guidelines have provided recommendations regarding management of IPMN without pancreatectomy,11, 12, 13, 19 an adequate surveillance protocol has not yet been established. Whereas BD‐IPMN infrequently develop invasive carcinoma, the incidence of PDAC concomitant with BD‐IPMN (4.5‐8.3%) is reportedly higher than that of malignant transformation of BD‐IPMN (0.0‐3.0%)52, 53, 54, 55 (Table 5).…”

Section: Surveillance For Ipmn Without Pancreatectomymentioning

confidence: 99%

“…Hence, several guidelines have been developed with an aim to establish an adequate strategy for surgical resection and surveillance of IPMN. We identified 11 available guidelines and further compared three major guidelines of IPMN published by the International Association of Pancreatology in 2012 (IAP2012),11 European Study Group on Cystic Tumours of the Pancreas in 2013 (EURO),12 and American Gastroenterological Association in 2015 (AGA) 13. We also herein present a discussion of new topics that are pivotal for the next step in improving the surveillance and treatment of IPMN.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of guidelines for intraductal papillary mucinous neoplasm: What is the next step beyond the current guidelines?

Nakamura

Miyasaka

Sadakari

et al. 2017

Annals of Gastroent Surgery

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Management of intraductal papillary mucinous neoplasm is controversial, and several guidelines have aimed to establish an adequate strategy for surgical resection and surveillance. We compared various intraductal papillary mucinous neoplasm guidelines and considered new matters that are pivotal for improved treatment of intraductal papillary mucinous neoplasm. We identified and compared 11 published guidelines, three of which were major guidelines that mainly referred to the diagnosis and treatment of intraductal papillary mucinous neoplasm (International Association of Pancreatology 2012 guidelines, European Study Group on Cystic Tumours of the Pancreas 2013 guidelines, and American Gastroenterological Association 2015 guidelines). The main concerns of these three guidelines were indication for surgery and follow up of non‐resected lesions. Among the differences between the three guidelines, the period of surveillance recommended was the most controversial matter. Meanwhile, several nomograms have been proposed to improve the diagnosis of intraductal papillary mucinous neoplasm from the level of experts' experiences to that of rational systems. We discuss the adequate strategy of surveillance for intraductal papillary mucinous neoplasm with and without pancreatectomy and nomograms aiming to predict the risk of malignancy in patients with intraductal papillary mucinous neoplasm.

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Pancreatic Cyst Disease

Stark

Donahue

Reber

et al. 2016

JAMA

203

155

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International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas

Cited by 2,102 publications

References 180 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

Comparison of guidelines for intraductal papillary mucinous neoplasm: What is the next step beyond the current guidelines?

Pancreatic Cyst Disease

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