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Journal of Hepato-Biliary-Pancreatic Sciences

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01-05-2009 | Original article

Single-institution validation of the international consensus guidelines for treatment of branch duct intraductal papillary mucinous neoplasms of the pancreas

Authors: Kazuyuki Nagai, Ryuichiro Doi, Tatsuo Ito, Atsushi Kida, Masayuki Koizumi, Toshihiko Masui, Yoshiya Kawaguchi, Kohei Ogawa, Shinji Uemoto

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 3/2009

Abstract

Background

The international consensus guidelines (the guidelines) for management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas recommend surgical resection of branch duct IPMNs with any of the following features: cyst size >30 mm, mural nodules, main pancreatic duct diameter >6 mm, positive cytology, and symptoms. The aim of this study was to evaluate the usefulness of these guidelines for resection of branch duct IPMNs.

Methods

We reviewed 84 consecutive patients with branch duct IPMNs who underwent surgical resection at our hospital between January 1984 and December 2007.

Results

Sixty-nine patients had indications for resection according to the guidelines. Malignant IPMNs had significantly larger cysts than benign tumors (P = 0.026). Patients with malignant IPMNs had significantly more indications for resection than those with benign IPMNs (2.6 ± 1.0 vs. 1.7 ± 0.9, P < 0.001), and 36 of the 37 patients with malignant IPMNs had indications. The sensitivity of the guidelines for predicting malignancy was 97.3%. One of 15 patients without indications had malignancy, and the specificity was low (29.8%).

Conclusions

The guidelines show a high sensitivity for predicting malignancy of branch duct IPMNs, but the specificity is low. The cyst size and the total number of indications in each patient should be taken into account when predicting the risk of malignancy for branch duct IPMNs.

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Title: Single-institution validation of the international consensus guidelines for treatment of branch duct intraductal papillary mucinous neoplasms of the pancreas
Authors: Kazuyuki Nagai
Ryuichiro Doi
Tatsuo Ito
Atsushi Kida
Masayuki Koizumi
Toshihiko Masui
Yoshiya Kawaguchi
Kohei Ogawa
Shinji Uemoto
Publication date: 01-05-2009
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 3/2009
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-009-0068-8

At a glance: The STEP trials

Springer Medicine

Single-institution validation of the international consensus guidelines for treatment of branch duct intraductal papillary mucinous neoplasms of the pancreas

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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