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A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation
A. Manuel-Vázquez, A. Balakrishnan, P. Agami, B. Andersson, F. Berrevoet, MG. Besselink, U. Boggi, D. Caputo, A. Carabias, L. Carrion-Alvarez, CC. Franco, A. Coppola, BVM. Dasari, S. Diaz-Mercedes, M. Feretis, C. Fondevila, GK. Fusai, G. Garcea,...
Language English Country Germany
Document type Observational Study, Multicenter Study, Journal Article
NLK
Medline Complete (EBSCOhost)
from 2000-01-01 to 1 year ago
Springer Nature OA/Free Journals
from 1872-03-01
- MeSH
- Carcinoma, Pancreatic Ductal * surgery pathology MeSH
- Pancreatic Intraductal Neoplasms * surgery pathology MeSH
- Humans MeSH
- Adenocarcinoma, Mucinous * surgery pathology MeSH
- Pancreatic Neoplasms * surgery pathology MeSH
- Pancreas surgery MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
PURPOSE: A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort. METHODS: An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included. RESULTS: A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%. CONCLUSION: Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.
Academic Medical Center Amsterdam The Netherlands
Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello Palermo Italy
Clínica Universidad De Navarra Pamplona Spain
Department of Gastrointestinal Surgery Stavanger University Hospital Stavanger Norway
Department of General and Digestive Surgery Hospital Universitario Rio Hortega Valladolid Spain
Department of Hepatopancreatobiliary Surgery Addenbrooke's Hospital Cambridge UK
Department of HPB Surgery and Liver Transplant Royal Free Hospital NHS Foundation Trust London UK
Department of HPB Surgery Oxford University Hospital NHS Foundation Trust Oxford UK
Department of HPB Surgery University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK
Department of Pathology Hospital Clinic IDIBAPS University of Barcelona Barcelona Spain
Department of Pathology Hospital Clínico Universitario Virgen de La Arrixaca Murcia Spain
Department of Surgery Miguel Servet University Hospital Saragossa Spain
Department of Surgery Military University Hospital Prague Prague Czech Republic
Department of Surgery Regional Hospital Ca Foncello Azienda ULSS2 Marca Trevigiana Treviso Italy
Department of Surgery St Vincent's University Hospital Dublin Ireland
Department of Surgery University Hospital of Larissa Larissa Greece
Department of Surgery University Hospital Southampton NHS Foundation Trust Southampton UK
Division of General and Transplant Surgery University of Pisa Pisa Italy
Division of HPB Surgery Department of Surgery Medisch Spectrum Twente Enschede The Netherlands
Freeman Hospital Newcastle upon Tyne UK
General Surgery Department HPB Unit Fuenlabrada University Hospital Madrid Spain
General Surgery Department Medico University of Rome Campus Bio Rome Italy
Hospital General Universitario de Alicante Alicante Spain
Hospital Regional de Málaga Malaga Spain
Hospital Universitario De Guadalajara Guadalajara Spain
Hospital Universitario Doctor Peset Valencia Spain
Hospital Universitario Puerta Del Mar Cadiz Spain
Hospital Universitario San Juan De Alicante Alicante Spain
HPB Surgery Hospital Clínico Universitario Virgen de La Arrixaca Murcia Spain
HPB Surgery Hospital Prof Dr Fernando Fonseca Amadora Portugal
Leicester General Hospital University Hospitals of Leicester Leicester UK
References provided by Crossref.org
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- $a Manuel-Vázquez, Alba $u Department of General and Digestive Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12, 500, 28905, Madrid, Spain. alba_manuel_vazquez@hotmail.com $1 https://orcid.org/0000000232670274
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- $a A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation / $c A. Manuel-Vázquez, A. Balakrishnan, P. Agami, B. Andersson, F. Berrevoet, MG. Besselink, U. Boggi, D. Caputo, A. Carabias, L. Carrion-Alvarez, CC. Franco, A. Coppola, BVM. Dasari, S. Diaz-Mercedes, M. Feretis, C. Fondevila, GK. Fusai, G. Garcea, V. Gonzabay, MÁG. Bravo, M. Gorris, B. Hendrikx, C. Hidalgo-Salinas, P. Kadam, D. Karavias, E. Kauffmann, A. Kourdouli, V. La Vaccara, S. van Laarhoven, J. Leighton, MSL. Liem, N. Machairas, D. Magouliotis, A. Mahmoud, MV. Marino, M. Massani, PM. Requena, K. Mentor, N. Napoli, JHT. Nijhuis, A. Nikov, C. Nistri, V. Nunes, EO. Ruiz, S. Pandanaboyana, BP. Saborido, R. Pohnán, M. Popa, BS. Pérez, FS. Bueno, A. Serrablo, M. Serradilla-Martín, JRA. Skipworth, K. Soreide, D. Symeonidis, D. Zacharoulis, P. Zelga, D. Aliseda, MJC. Santiago, CF. Mancilla, RL. Fragua, DL. Hughes, CP. Llorente, M. Lesurtel, T. Gallagher, JM. Ramia, on behalf the Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA)
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- $a PURPOSE: A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort. METHODS: An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included. RESULTS: A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%. CONCLUSION: Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.
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