BACKGROUND: The objective of the present study was to identify reliable preoperative factors predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm (IPMN) of the pancreas and the effectiveness of a diagnostic scoring system based on these factors. METHODS: Between August 1994 and December 2007, 204 patients underwent pancreatic resection for IPMN at a single institute. Medical records were reviewed retrospectively, and a new diagnostic scoring system for predicting malignant IPMN preoperatively was designed. RESULTS: Univariate analysis revealed nine significant predictors of both malignant and invasive IPMN: age > or =60 years, history of pancreatitis, presence of mural nodule(s), diameter of main pancreatic duct (MPD) >6 mm, main duct or mixed type, total bilirubin >1.2 mg/dl, CA-19-9 >37 U/ml, tumor location in the pancreatic head, and tumor size >30 mm. Multivariate analysis showed that age, pancreatitis, mural nodule(s), and MPD diameter were independent predictors of invasive IPMN, and that all these parameters, plus elevated carbohydrate antigen-19-9 (CA-19-9), were independent predictors of malignant IPMN. A scoring system based on these five factors, each assigned 1 point, and with a cut-off of 3 points, could predict malignant IPMN with a sensitivity of 50.7% and a specificity of 90.1%. The 5-year survival rates of patients with benign and malignant IPMN were 95.0% and 64.0%, respectively. CONCLUSIONS: Our scoring system using five independent factors (age > or =60 years, history of pancreatitis, presence of mural nodule(s), elevated level of CA-19-9, and MPD diameter >6 mm) may be helpful for predicting malignancy and postoperative survival.
BACKGROUND: The objective of the present study was to identify reliable preoperative factors predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm (IPMN) of the pancreas and the effectiveness of a diagnostic scoring system based on these factors. METHODS: Between August 1994 and December 2007, 204 patients underwent pancreatic resection for IPMN at a single institute. Medical records were reviewed retrospectively, and a new diagnostic scoring system for predicting malignant IPMN preoperatively was designed. RESULTS: Univariate analysis revealed nine significant predictors of both malignant and invasive IPMN: age > or =60 years, history of pancreatitis, presence of mural nodule(s), diameter of main pancreatic duct (MPD) >6 mm, main duct or mixed type, total bilirubin >1.2 mg/dl, CA-19-9 >37 U/ml, tumor location in the pancreatic head, and tumor size >30 mm. Multivariate analysis showed that age, pancreatitis, mural nodule(s), and MPD diameter were independent predictors of invasive IPMN, and that all these parameters, plus elevated carbohydrate antigen-19-9 (CA-19-9), were independent predictors of malignant IPMN. A scoring system based on these five factors, each assigned 1 point, and with a cut-off of 3 points, could predict malignant IPMN with a sensitivity of 50.7% and a specificity of 90.1%. The 5-year survival rates of patients with benign and malignant IPMN were 95.0% and 64.0%, respectively. CONCLUSIONS: Our scoring system using five independent factors (age > or =60 years, history of pancreatitis, presence of mural nodule(s), elevated level of CA-19-9, and MPD diameter >6 mm) may be helpful for predicting malignancy and postoperative survival.
Authors: Suresh T Chari; Dhiraj Yadav; Thomas C Smyrk; Eugene P DiMagno; Laurence J Miller; Massimo Raimondo; Jonathan E Clain; Ian A Norton; Randall K Pearson; Bret T Petersen; Maurits J Wiersema; Michael B Farnell; Michael G Sarr Journal: Gastroenterology Date: 2002-11 Impact factor: 22.682
Authors: F Maire; P Hammel; B Terris; F Paye; J-Y Scoazec; C Cellier; M Barthet; D O'Toole; P Rufat; C Partensky; E Cuillerier; P Lévy; J Belghiti; P Ruszniewski Journal: Gut Date: 2002-11 Impact factor: 23.059
Authors: Marco Niedergethmann; Robert Grützmann; Ralf Hildenbrand; Dag Dittert; Niloufar Aramin; Melanie Franz; Frank Dobrowolski; Stefan Post; Hans-Detlev Saeger Journal: World J Surg Date: 2008-10 Impact factor: 3.352
Authors: Taylor A Sohn; Charles J Yeo; John L Cameron; Ralph H Hruban; Noriyoshi Fukushima; Kurtis A Campbell; Keith D Lillemoe Journal: Ann Surg Date: 2004-06 Impact factor: 12.969
Authors: Chakshu Sharma; Karim M Eltawil; Paul D Renfrew; Mark J Walsh; Michele Molinari Journal: World J Gastroenterol Date: 2011-02-21 Impact factor: 5.742
Authors: Muriel Genevay; Mari Mino-Kenudson; Kurt Yaeger; Ioannis T Konstantinidis; Cristina R Ferrone; Sarah Thayer; Carlos Fernandez-del Castillo; Dushyant Sahani; Brenna Bounds; David Forcione; William R Brugge; Martha Bishop Pitman Journal: Ann Surg Date: 2011-12 Impact factor: 12.969
Authors: Lawrence Mj Best; Vishal Rawji; Stephen P Pereira; Brian R Davidson; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2017-04-17