Validity of the management strategy for intraductal papillary mucinous neoplasm advocated by the international consensus guidelines 2012: a retrospective review

Yusuke Watanabe, Kazuyoshi Nishihara, Yusuke Niina, Yuji Abe, Takao Amaike, Shin Kibe, yusuke mizuuchi, Daisuke Kakihara, Minoru Ono, Sadafumi Tamiya, Satoshi Toyoshima, Toru Nakano, Shoshu Mitsuyama

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Abstract

Purpose: The aim of this study was to investigate the validity of the management strategy for intraductal papillary mucinous neoplasms (IPMNs) advocated by the international consensus guidelines 2012 (ICG2012). Methods: The medical records of 49 patients who underwent pancreatectomy for IPMN were retrospectively reviewed. Results: According to preoperative imaging, 10 patients (20 %) had main-duct IPMNs, 20 (41 %) had mixed IPMNs, and 19 (39 %) had branch-duct IPMNs, with malignancy frequencies of 80, 15, and 37 %, respectively. Twenty-seven patients had high-risk stigmata and 21 had worrisome features, with malignancy frequencies of 59 and 10 %, respectively. The sensitivity, specificity, and positive and negative predictive values of high-risk stigmata for malignancy were 88, 65, 59, and 91 %, respectively. Lesions were malignant in 88 % of patients with an enhanced solid component, which was significantly correlated with the prevalence of malignancy (P < 0.01). However, of the 10 patients who underwent pancreatectomy solely due to a main pancreatic dilation of ≥10 mm, 9 (90 %) had benign IPMNs. Conclusions: Many mixed IPMNs defined according to ICG2012 are benign. Although the management strategy advocated by ICG2012 has been improved relative to the Sendai criteria, the different high-risk stigmata carry unequal weights. Consequently, ICG2012 remains suboptimal for predicting malignant IPMN.

Original languageEnglish
Pages (from-to)1045-1052
Number of pages8
JournalSurgery today
Volume46
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

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Guidelines
Neoplasms
Christianity
Pancreatectomy
Medical Records
Dilatation
Weights and Measures
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Surgery

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Validity of the management strategy for intraductal papillary mucinous neoplasm advocated by the international consensus guidelines 2012 : a retrospective review. / Watanabe, Yusuke; Nishihara, Kazuyoshi; Niina, Yusuke; Abe, Yuji; Amaike, Takao; Kibe, Shin; mizuuchi, yusuke; Kakihara, Daisuke; Ono, Minoru; Tamiya, Sadafumi; Toyoshima, Satoshi; Nakano, Toru; Mitsuyama, Shoshu.

In: Surgery today, Vol. 46, No. 9, 01.09.2016, p. 1045-1052.

Research output: Contribution to journalArticle

Watanabe, Y, Nishihara, K, Niina, Y, Abe, Y, Amaike, T, Kibe, S, mizuuchi, Y, Kakihara, D, Ono, M, Tamiya, S, Toyoshima, S, Nakano, T & Mitsuyama, S 2016, 'Validity of the management strategy for intraductal papillary mucinous neoplasm advocated by the international consensus guidelines 2012: a retrospective review', Surgery today, vol. 46, no. 9, pp. 1045-1052. https://doi.org/10.1007/s00595-015-1292-2
Watanabe, Yusuke ; Nishihara, Kazuyoshi ; Niina, Yusuke ; Abe, Yuji ; Amaike, Takao ; Kibe, Shin ; mizuuchi, yusuke ; Kakihara, Daisuke ; Ono, Minoru ; Tamiya, Sadafumi ; Toyoshima, Satoshi ; Nakano, Toru ; Mitsuyama, Shoshu. / Validity of the management strategy for intraductal papillary mucinous neoplasm advocated by the international consensus guidelines 2012 : a retrospective review. In: Surgery today. 2016 ; Vol. 46, No. 9. pp. 1045-1052.
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abstract = "Purpose: The aim of this study was to investigate the validity of the management strategy for intraductal papillary mucinous neoplasms (IPMNs) advocated by the international consensus guidelines 2012 (ICG2012). Methods: The medical records of 49 patients who underwent pancreatectomy for IPMN were retrospectively reviewed. Results: According to preoperative imaging, 10 patients (20 {\%}) had main-duct IPMNs, 20 (41 {\%}) had mixed IPMNs, and 19 (39 {\%}) had branch-duct IPMNs, with malignancy frequencies of 80, 15, and 37 {\%}, respectively. Twenty-seven patients had high-risk stigmata and 21 had worrisome features, with malignancy frequencies of 59 and 10 {\%}, respectively. The sensitivity, specificity, and positive and negative predictive values of high-risk stigmata for malignancy were 88, 65, 59, and 91 {\%}, respectively. Lesions were malignant in 88 {\%} of patients with an enhanced solid component, which was significantly correlated with the prevalence of malignancy (P < 0.01). However, of the 10 patients who underwent pancreatectomy solely due to a main pancreatic dilation of ≥10 mm, 9 (90 {\%}) had benign IPMNs. Conclusions: Many mixed IPMNs defined according to ICG2012 are benign. Although the management strategy advocated by ICG2012 has been improved relative to the Sendai criteria, the different high-risk stigmata carry unequal weights. Consequently, ICG2012 remains suboptimal for predicting malignant IPMN.",
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T2 - a retrospective review

AU - Watanabe, Yusuke

AU - Nishihara, Kazuyoshi

AU - Niina, Yusuke

AU - Abe, Yuji

AU - Amaike, Takao

AU - Kibe, Shin

AU - mizuuchi, yusuke

AU - Kakihara, Daisuke

AU - Ono, Minoru

AU - Tamiya, Sadafumi

AU - Toyoshima, Satoshi

AU - Nakano, Toru

AU - Mitsuyama, Shoshu

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Y1 - 2016/9/1

N2 - Purpose: The aim of this study was to investigate the validity of the management strategy for intraductal papillary mucinous neoplasms (IPMNs) advocated by the international consensus guidelines 2012 (ICG2012). Methods: The medical records of 49 patients who underwent pancreatectomy for IPMN were retrospectively reviewed. Results: According to preoperative imaging, 10 patients (20 %) had main-duct IPMNs, 20 (41 %) had mixed IPMNs, and 19 (39 %) had branch-duct IPMNs, with malignancy frequencies of 80, 15, and 37 %, respectively. Twenty-seven patients had high-risk stigmata and 21 had worrisome features, with malignancy frequencies of 59 and 10 %, respectively. The sensitivity, specificity, and positive and negative predictive values of high-risk stigmata for malignancy were 88, 65, 59, and 91 %, respectively. Lesions were malignant in 88 % of patients with an enhanced solid component, which was significantly correlated with the prevalence of malignancy (P < 0.01). However, of the 10 patients who underwent pancreatectomy solely due to a main pancreatic dilation of ≥10 mm, 9 (90 %) had benign IPMNs. Conclusions: Many mixed IPMNs defined according to ICG2012 are benign. Although the management strategy advocated by ICG2012 has been improved relative to the Sendai criteria, the different high-risk stigmata carry unequal weights. Consequently, ICG2012 remains suboptimal for predicting malignant IPMN.

AB - Purpose: The aim of this study was to investigate the validity of the management strategy for intraductal papillary mucinous neoplasms (IPMNs) advocated by the international consensus guidelines 2012 (ICG2012). Methods: The medical records of 49 patients who underwent pancreatectomy for IPMN were retrospectively reviewed. Results: According to preoperative imaging, 10 patients (20 %) had main-duct IPMNs, 20 (41 %) had mixed IPMNs, and 19 (39 %) had branch-duct IPMNs, with malignancy frequencies of 80, 15, and 37 %, respectively. Twenty-seven patients had high-risk stigmata and 21 had worrisome features, with malignancy frequencies of 59 and 10 %, respectively. The sensitivity, specificity, and positive and negative predictive values of high-risk stigmata for malignancy were 88, 65, 59, and 91 %, respectively. Lesions were malignant in 88 % of patients with an enhanced solid component, which was significantly correlated with the prevalence of malignancy (P < 0.01). However, of the 10 patients who underwent pancreatectomy solely due to a main pancreatic dilation of ≥10 mm, 9 (90 %) had benign IPMNs. Conclusions: Many mixed IPMNs defined according to ICG2012 are benign. Although the management strategy advocated by ICG2012 has been improved relative to the Sendai criteria, the different high-risk stigmata carry unequal weights. Consequently, ICG2012 remains suboptimal for predicting malignant IPMN.

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