W Jung1,2, T Park3, Y Kim3, H Park3, Y Han1, J He4, C L Wolfgang4, A Blair4, M F Rashid5, M D Kluger5, G H Su6, J A Chabot5, C-Y Yang7, W Lou8, R Valente9,10, M Del Chiaro9, Y-M Shyr11, S-E Wang11, N C M van Huijgevoort12, M G Besselink13, Y Yang14, H Kim1, W Kwon1, S-W Kim1, J-Y Jang1. 1. Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Surgery, Ajou University School of Medicine, Suwon, Korea. 3. Department of Statistics, Seoul National University College of Natural Sciences, Seoul, Korea. 4. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 5. Department of Surgery, Division of Gastrointestinal and Endocrine Surgery, Columbia University, College of Physicians and Surgeon, New York, USA. 6. Department of Pathology and Cell Biology, Columbia University Medical Center, New York, USA. 7. Division of General Surgery, Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. 8. Department of Pancreatic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. 9. Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute at Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. 10. Digestive and Liver Disease Unit, Sapienza University of Rome, Rome, Italy. 11. Departments of Surgery, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan. 12. Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Academic Medical Centre, Amsterdam, the Netherlands. 13. Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 14. Department of General Surgery, Peking University First Hospital, Beijing, China.
Abstract
BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is premalignant pancreatic lesion. International guidelines offer limited predictors of individual risk. A nomogram to predict individual IPMN malignancy risk was released, with good diagnostic performance based on a large cohort of Asian patients with IPMN. The present study validated a nomogram to predict malignancy risk and invasiveness of IPMN using both Eastern and Western cohorts. METHODS: Clinicopathological and radiological data from patients who underwent pancreatic resection for IPMN at four centres each in Eastern and Western countries were collected. After excluding patients with missing data for at least one malignancy predictor in the nomogram (main pancreatic duct diameter, cyst size, presence of mural nodule, serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 levels, and age). RESULTS: In total, data from 393 patients who fit the criteria were analysed, of whom 265 were from Eastern and 128 from Western institutions. Although mean age, sex, log value of serum CA19-9 level, tumour location, main duct diameter, cyst size and presence of mural nodule differed between the Korean/Japanese, Eastern and Western cohorts, rates of malignancy and invasive cancer did not differ significantly. Areas under the receiver operating characteristic (ROC) curve values for the nomogram predicting malignancy were 0·745 for Eastern, 0·856 for Western and 0·776 for combined cohorts; respective values for the nomogram predicting invasiveness were 0·736, 0·891 and 0·788. CONCLUSIONS: External validation of the nomogram showed good performance in predicting cancer in both Eastern and Western patients with IPMN lesions.
BACKGROUND:Intraductal papillary mucinous neoplasm (IPMN) is premalignant pancreatic lesion. International guidelines offer limited predictors of individual risk. A nomogram to predict individual IPMNmalignancy risk was released, with good diagnostic performance based on a large cohort of Asian patients with IPMN. The present study validated a nomogram to predict malignancy risk and invasiveness of IPMN using both Eastern and Western cohorts. METHODS: Clinicopathological and radiological data from patients who underwent pancreatic resection for IPMN at four centres each in Eastern and Western countries were collected. After excluding patients with missing data for at least one malignancy predictor in the nomogram (main pancreatic duct diameter, cyst size, presence of mural nodule, serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 levels, and age). RESULTS: In total, data from 393 patients who fit the criteria were analysed, of whom 265 were from Eastern and 128 from Western institutions. Although mean age, sex, log value of serum CA19-9 level, tumour location, main duct diameter, cyst size and presence of mural nodule differed between the Korean/Japanese, Eastern and Western cohorts, rates of malignancy and invasive cancer did not differ significantly. Areas under the receiver operating characteristic (ROC) curve values for the nomogram predicting malignancy were 0·745 for Eastern, 0·856 for Western and 0·776 for combined cohorts; respective values for the nomogram predicting invasiveness were 0·736, 0·891 and 0·788. CONCLUSIONS: External validation of the nomogram showed good performance in predicting cancer in both Eastern and Western patients with IPMN lesions.
Authors: Sophia Kwon; Myeonggyun Lee; George Crowley; Theresa Schwartz; Rachel Zeig-Owens; David J Prezant; Mengling Liu; Anna Nolan Journal: Am J Respir Crit Care Med Date: 2021-11-01 Impact factor: 21.405