BACKGROUND: The international consensus guidelines (the guidelines) for management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas recommend surgical resection of branch duct IPMNs with any of the following features: cyst size >30 mm, mural nodules, main pancreatic duct diameter >6 mm, positive cytology, and symptoms. The aim of this study was to evaluate the usefulness of these guidelines for resection of branch duct IPMNs. METHODS: We reviewed 84 consecutive patients with branch duct IPMNs who underwent surgical resection at our hospital between January 1984 and December 2007. RESULTS: Sixty-nine patients had indications for resection according to the guidelines. Malignant IPMNs had significantly larger cysts than benign tumors (P = 0.026). Patients with malignant IPMNs had significantly more indications for resection than those with benign IPMNs (2.6 +/- 1.0 vs. 1.7 +/- 0.9, P < 0.001), and 36 of the 37 patients with malignant IPMNs had indications. The sensitivity of the guidelines for predicting malignancy was 97.3%. One of 15 patients without indications had malignancy, and the specificity was low (29.8%). CONCLUSIONS: The guidelines show a high sensitivity for predicting malignancy of branch duct IPMNs, but the specificity is low. The cyst size and the total number of indications in each patient should be taken into account when predicting the risk of malignancy for branch duct IPMNs.
BACKGROUND: The international consensus guidelines (the guidelines) for management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas recommend surgical resection of branch duct IPMNs with any of the following features: cyst size >30 mm, mural nodules, main pancreatic duct diameter >6 mm, positive cytology, and symptoms. The aim of this study was to evaluate the usefulness of these guidelines for resection of branch duct IPMNs. METHODS: We reviewed 84 consecutive patients with branch duct IPMNs who underwent surgical resection at our hospital between January 1984 and December 2007. RESULTS: Sixty-nine patients had indications for resection according to the guidelines. Malignant IPMNs had significantly larger cysts than benign tumors (P = 0.026). Patients with malignant IPMNs had significantly more indications for resection than those with benign IPMNs (2.6 +/- 1.0 vs. 1.7 +/- 0.9, P < 0.001), and 36 of the 37 patients with malignant IPMNs had indications. The sensitivity of the guidelines for predicting malignancy was 97.3%. One of 15 patients without indications had malignancy, and the specificity was low (29.8%). CONCLUSIONS: The guidelines show a high sensitivity for predicting malignancy of branch duct IPMNs, but the specificity is low. The cyst size and the total number of indications in each patient should be taken into account when predicting the risk of malignancy for branch duct IPMNs.
Authors: Marc A Attiyeh; Carlos Fernández-Del Castillo; Mohammad Al Efishat; Anne A Eaton; Mithat Gönen; Ruqayyah Batts; Ilaria Pergolini; Neda Rezaee; Keith D Lillemoe; Cristina R Ferrone; Mari Mino-Kenudson; Matthew J Weiss; John L Cameron; Ralph H Hruban; Michael I D'Angelica; Ronald P DeMatteo; T Peter Kingham; William R Jarnagin; Christopher L Wolfgang; Peter J Allen Journal: Ann Surg Date: 2018-01 Impact factor: 12.969
Authors: Jon Broughton; Jeremy Lipschitz; Michael Cantor; Dana Moffatt; Ahmed Abdoh; Andrew McKay Journal: HPB (Oxford) Date: 2016-01-29 Impact factor: 3.647
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Authors: Dirk Bausch; Mari Mino-Kenudson; Carlos Fernández-Del Castillo; Andrew L Warshaw; Kimberly A Kelly; Sarah P Thayer Journal: J Gastrointest Surg Date: 2009-09-17 Impact factor: 3.452