INTRODUCTION: The risk of malignancy in branch duct intraductal papillary mucinous neoplasia of the pancreas (BD-IPMN) is controversially debated. An increasing number of studies report on outcomes using the Sendai or Fukuoka consensus criteria for treatment decision-making. The objective of this work was to evaluate the diagnostic accuracy of the Sendai and Fukuoka criteria. METHODS: We systematically reviewed studies on Sendai or Fukuoka criteria-guided management of BD-IPMN. Pooled sensitivity, specificity and diagnostic odds ratios as compound measures of diagnostic accuracy were calculated from studies matching the inclusion criteria. The meta-analysis was performed using a random effects model. RESULTS: Fifteen studies with a total of 2710 patients were included. Twelve of these used the Sendai criteria. In these studies, 23% of Sendai-negative patients had a high grade dysplastic lesion or an invasive carcinoma in final histology. Pooled sensitivity was 56%, specificity was 74% and the diagnostic odds ratio for malignancy in Sendai-positive lesions was 7.45. When the results of follow-up examinations were included, diagnostic accuracy improved significantly (14.66, p < 0.001). Three studies were identified that used the Fukuoka criteria for decision making. Of 200 patients with Fukuoka-negative lesions who underwent surgery, 22 had a malignant lesion in final histology (11%). Pooled sensitivity was 83%, specificity was 53% and the diagnostic odds ratio was 8.76. CONCLUSION: The Fukuoka criteria have considerably improved sensitivity but still lack adequate specificity. For further reduction of a potential surgical overtreatment of BD-IPMN, the development of criteria with an increased specificity is required.
INTRODUCTION: The risk of malignancy in branch duct intraductal papillary mucinous neoplasia of the pancreas (BD-IPMN) is controversially debated. An increasing number of studies report on outcomes using the Sendai or Fukuoka consensus criteria for treatment decision-making. The objective of this work was to evaluate the diagnostic accuracy of the Sendai and Fukuoka criteria. METHODS: We systematically reviewed studies on Sendai or Fukuoka criteria-guided management of BD-IPMN. Pooled sensitivity, specificity and diagnostic odds ratios as compound measures of diagnostic accuracy were calculated from studies matching the inclusion criteria. The meta-analysis was performed using a random effects model. RESULTS: Fifteen studies with a total of 2710 patients were included. Twelve of these used the Sendai criteria. In these studies, 23% of Sendai-negative patients had a high grade dysplastic lesion or an invasive carcinoma in final histology. Pooled sensitivity was 56%, specificity was 74% and the diagnostic odds ratio for malignancy in Sendai-positive lesions was 7.45. When the results of follow-up examinations were included, diagnostic accuracy improved significantly (14.66, p < 0.001). Three studies were identified that used the Fukuoka criteria for decision making. Of 200 patients with Fukuoka-negative lesions who underwent surgery, 22 had a malignant lesion in final histology (11%). Pooled sensitivity was 83%, specificity was 53% and the diagnostic odds ratio was 8.76. CONCLUSION: The Fukuoka criteria have considerably improved sensitivity but still lack adequate specificity. For further reduction of a potential surgical overtreatment of BD-IPMN, the development of criteria with an increased specificity is required.
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Authors: Alan R Penheiter; Dinesh K Deelchand; Emily Kittelson; Sibel Erdogan Damgard; Stephen J Murphy; Daniel R O'Brien; William R Bamlet; Marie R Passow; Thomas C Smyrk; Fergus J Couch; George Vasmatzis; John D Port; Małgorzata Marjańska; Stephanie K Carlson Journal: Pancreatology Date: 2017-11-14 Impact factor: 3.996
Authors: Kate A Harrington; Travis L Williams; Sharon A Lawrence; Jayasree Chakraborty; Mohammad A Al Efishat; Marc A Attiyeh; Gokce Askan; Yuting Chou; Alessandra Pulvirenti; Caitlin A McIntyre; Mithat Gonen; Olca Basturk; Vinod P Balachandran; T Peter Kingham; Michael I D'Angelica; William R Jarnagin; Jeffrey A Drebin; Richard K Do; Peter J Allen; Amber L Simpson Journal: J Med Imaging (Bellingham) Date: 2020-06-25
Authors: Vincent Bernard; Alexander Semaan; Jonathan Huang; F Anthony San Lucas; Feven C Mulu; Bret M Stephens; Paola A Guerrero; Yanqing Huang; Jun Zhao; Nabiollah Kamyabi; Subrata Sen; Paul A Scheet; Cullen M Taniguchi; Michael P Kim; Ching-Wei Tzeng; Matthew H Katz; Aatur D Singhi; Anirban Maitra; Hector A Alvarez Journal: Clin Cancer Res Date: 2018-11-01 Impact factor: 12.531