Yasuhiro Shimizu1, Hiroki Yamaue, Hiroyuki Maguchi, Kenji Yamao, Seiko Hirono, Manabu Osanai, Susumu Hijioka, Yukihide Kanemitsu, Tsuyoshi Sano, Yoshiki Senda, Vikram Bhatia, Akio Yanagisawa. 1. From the *Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya; †Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama; ‡Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo; §Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya; ∥Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan; ¶Department of Medical Hepatology, Institute of Liver and Biliary Sciences, Delhi, India; and #Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Abstract
OBJECTIVE: We previously published a nomogram for prediction of carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). The objective of the current study was to validate this nomogram in an external cohort of patients at multiple institutions. METHODS: The clinical details of 180 patients with IPMN who underwent a pancreatic resection at 3 hospitals were collected. Four significant predictive factors (sex, lesion type, nodule height, and pancreatic juice cytology) were analyzed. RESULTS: Of the 180 patients, 66 (36.7%) had a main pancreatic duct-type IPMN and 114 (63.3%) had a branch pancreatic duct-type IPMN. The final pathological diagnosis was benign IPMN in 95 (52.8%) patients and malignant IPMN in 85 (47.2%) patients. The area under the receiver operating characteristic curve for the model was 0.760. The area under the receiver operating characteristic curve of the IPMN nomogram for prediction of malignancy was 0.747 in main pancreatic duct-type IPMN and 0.752 in branch pancreatic duct-type IPMN. The sensitivity and specificity of the model were 80.0% and 57.9%, respectively, when the predictive probability of more than 10% was used to indicate the presence of carcinoma. CONCLUSIONS: This nomogram for predicting the probability of carcinoma in patients with IPMN was accurate in an external validation patient cohort.
OBJECTIVE: We previously published a nomogram for prediction of carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). The objective of the current study was to validate this nomogram in an external cohort of patients at multiple institutions. METHODS: The clinical details of 180 patients with IPMN who underwent a pancreatic resection at 3 hospitals were collected. Four significant predictive factors (sex, lesion type, nodule height, and pancreatic juice cytology) were analyzed. RESULTS: Of the 180 patients, 66 (36.7%) had a main pancreatic duct-type IPMN and 114 (63.3%) had a branch pancreatic duct-type IPMN. The final pathological diagnosis was benign IPMN in 95 (52.8%) patients and malignant IPMN in 85 (47.2%) patients. The area under the receiver operating characteristic curve for the model was 0.760. The area under the receiver operating characteristic curve of the IPMN nomogram for prediction of malignancy was 0.747 in main pancreatic duct-type IPMN and 0.752 in branch pancreatic duct-type IPMN. The sensitivity and specificity of the model were 80.0% and 57.9%, respectively, when the predictive probability of more than 10% was used to indicate the presence of carcinoma. CONCLUSIONS: This nomogram for predicting the probability of carcinoma in patients with IPMN was accurate in an external validation patient cohort.
Authors: Mohammad A Al Efishat; Marc A Attiyeh; Anne A Eaton; Mithat Gönen; Denise Prosser; Anna E Lokshin; Carlos Fernández-Del Castillo; Keith D Lillemoe; Cristina R Ferrone; Ilaria Pergolini; Mari Mino-Kenudson; Neda Rezaee; Marco Dal Molin; Matthew J Weiss; John L Cameron; Ralph H Hruban; Michael I D'Angelica; T Peter Kingham; Ronald P DeMatteo; William R Jarnagin; Christopher L Wolfgang; Peter J Allen Journal: Ann Surg Date: 2018-08 Impact factor: 12.969
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