OBJECTIVES: This study investigated whether a risk assessment nomogram can predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs) and provide valuable information for the follow-up and counseling strategies of such patients. METHODS: We studied 126 of 589 patients with IPMN who were followed up for at least 36 months with annual endoscopic ultrasonography. We analyzed scores derived from our nomogram, incorporating the parameters of sex, lesion type, mural nodule height, and pancreatic juice cytology determined at the initial IPMN evaluation. RESULTS: The rate of malignant IPMNs was 5.5% (7/126). The initial average nomogram score was 19.8 (range, 0-55), and the final follow-up average was 23.8 (range, 0-109). When a cutoff score was set at 35 points, the sensitivity, specificity, and accuracy of the nomogram to assess malignancy risk were 87.5%, 96.6%, and 96%, respectively. The area under the receiver operating characteristic curve of malignant IPMN prediction during follow-up was 0.865. CONCLUSIONS: The ability of the nomogram to predict malignancy in patients with IPMN was validated. Our findings can suggest that a follow-up for patients at high and low risk for cancer progression could be scheduled every 3 to 6 and 12 months, respectively.
OBJECTIVES: This study investigated whether a risk assessment nomogram can predict the malignant potential of intraductal papillary mucinous neoplasms (IPMNs) and provide valuable information for the follow-up and counseling strategies of such patients. METHODS: We studied 126 of 589 patients with IPMN who were followed up for at least 36 months with annual endoscopic ultrasonography. We analyzed scores derived from our nomogram, incorporating the parameters of sex, lesion type, mural nodule height, and pancreatic juice cytology determined at the initial IPMN evaluation. RESULTS: The rate of malignant IPMNs was 5.5% (7/126). The initial average nomogram score was 19.8 (range, 0-55), and the final follow-up average was 23.8 (range, 0-109). When a cutoff score was set at 35 points, the sensitivity, specificity, and accuracy of the nomogram to assess malignancy risk were 87.5%, 96.6%, and 96%, respectively. The area under the receiver operating characteristic curve of malignant IPMN prediction during follow-up was 0.865. CONCLUSIONS: The ability of the nomogram to predict malignancy in patients with IPMN was validated. Our findings can suggest that a follow-up for patients at high and low risk for cancer progression could be scheduled every 3 to 6 and 12 months, respectively.
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: Lawrence Mj Best; Vishal Rawji; Stephen P Pereira; Brian R Davidson; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2017-04-17
Authors: Kasper A Overbeek; Maaike Alblas; Valerie Gausman; Pujan Kandel; Adam B Schweber; Christian Brooks; Priscilla A Van Riet; Michael B Wallace; Tamas A Gonda; Djuna L Cahen; Marco J Bruno Journal: Aliment Pharmacol Ther Date: 2019-08-19 Impact factor: 8.171