Nandhini Srinivasan1, Jin-Yao Teo2, Yung-Ka Chin3, Tiffany Hennedige4, Damien M Tan3, Albert S Low5, Choon Hua Thng4, Brian K P Goh6. 1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 2. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. 3. Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. 4. Department of Oncologic Imaging, National Cancer Center Singapore, Singapore; Duke-NUS Medical School Singapore, Singapore. 5. Department of Diagnostic Radiology, Singapore General Hospital, Singapore. 6. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore; Duke-NUS Medical School Singapore, Singapore. Electronic address: bsgkp@hotmail.com.
Abstract
BACKGROUND: This systematic review was performed to assess the clinical utility of the Sendai Consensus Guidelines (SCG) and Fukuoka Consensus Guidelines (FCG) for intraductal papillary mucinous neoplasm (IPMN). METHODS: A computerized search of PubMed was performed to identify all the studies which evaluated the SCG and FCG in surgically resected, histologically confirmed IPMNs. RESULTS: Ten studies evaluating the FCG, 8 evaluating the SCG and 4 evaluating both guidelines were included. In 14 studies evaluating the FCG, out of a total of 2498 neoplasms, 849 were malignant and 1649 were benign neoplasms. Pooled analysis showed that 751 of 1801 (42%) FCG+ve neoplasms were malignant and 599 neoplasms of 697 (86%) FCG-ve neoplasms were benign. PPV of the high risk and worrisome risk groups were 465/986 (47%) and 239/520 (46%) respectively. In 12 studies evaluating the SCG, 1234 neoplasms were analyzed of which 388 (31%) were malignant and 846 (69%) were benign. Pooled analysis demonstrated that 265 of 802 (33%) SCG+ve neoplasms were malignant and 238 of 266 SCG-ve (90%) neoplasms were benign. CONCLUSION: The FCG had a higher positive predictive value (PPV) compared to the SCG. However, the negative predictive value (NPV) of the FCG was slightly lower than that of the SCG. Malignant and even invasive IPMN may be missed according to both guidelines.
BACKGROUND: This systematic review was performed to assess the clinical utility of the Sendai Consensus Guidelines (SCG) and Fukuoka Consensus Guidelines (FCG) for intraductal papillary mucinous neoplasm (IPMN). METHODS: A computerized search of PubMed was performed to identify all the studies which evaluated the SCG and FCG in surgically resected, histologically confirmed IPMNs. RESULTS: Ten studies evaluating the FCG, 8 evaluating the SCG and 4 evaluating both guidelines were included. In 14 studies evaluating the FCG, out of a total of 2498 neoplasms, 849 were malignant and 1649 were benign neoplasms. Pooled analysis showed that 751 of 1801 (42%) FCG+ve neoplasms were malignant and 599 neoplasms of 697 (86%) FCG-ve neoplasms were benign. PPV of the high risk and worrisome risk groups were 465/986 (47%) and 239/520 (46%) respectively. In 12 studies evaluating the SCG, 1234 neoplasms were analyzed of which 388 (31%) were malignant and 846 (69%) were benign. Pooled analysis demonstrated that 265 of 802 (33%) SCG+ve neoplasms were malignant and 238 of 266 SCG-ve (90%) neoplasms were benign. CONCLUSION: The FCG had a higher positive predictive value (PPV) compared to the SCG. However, the negative predictive value (NPV) of the FCG was slightly lower than that of the SCG. Malignant and even invasive IPMN may be missed according to both guidelines.
Authors: Tri Huynh; Karla Ali; Shraddha Vyas; Kaleena Dezsi; Destiny Strickland; Toni Basinski; Dung-Tsa Chen; Kun Jiang; Barbara Centeno; Mokenge Malafa; Jason B Klapman; Pamela J Hodul; Daniel Jeong; Jennifer B Permuth Journal: Pancreatology Date: 2020-02-21 Impact factor: 3.996
Authors: Alessandra Pulvirenti; Georgios A Margonis; Vicente Morales-Oyarvide; Caitlin A McIntyre; Sharon A Lawrence; Debra A Goldman; Mithat Gonen; Matthew J Weiss; Cristina R Ferrone; Jin He; Murray F Brennan; John L Cameron; Keith D Lillemoe; T Peter Kingham; Vinod Balachandran; Motaz Qadan; Michael I D'Angelica; William R Jarnagin; Christopher L Wolfgang; Carlos Fernández-Del Castillo; Peter J Allen Journal: Ann Surg Date: 2021-12-01 Impact factor: 13.787