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

研究成果: ジャーナルへの寄稿記事

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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.

元の言語英語
ページ(範囲)1045-1052
ページ数8
ジャーナルSurgery today
46
発行部数9
DOI
出版物ステータス出版済み - 9 1 2016

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All Science Journal Classification (ASJC) codes

  • Surgery

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