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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,...

. 2022 ; 407 (8) : 3447-3455. [pub] 20221006

Jazyk angličtina Země Německo

Typ dokumentu pozorovací studie, multicentrická studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22032392

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 Clinical Sciences Lund Surgery Lund University and Skåne University Hospital Lund Sweden

Department of Digestive Surgery and Liver Transplantation Croix Rousse University Hospital University of Lyon 1 Hospices Civils de Lyon Lyon France

Department of Gastrointestinal Surgery Stavanger University Hospital Stavanger Norway

Department of General and Digestive Surgery Hospital Clinic IDIBAPS University of Barcelona Barcelona CIBERehd Spain

Department of General and Digestive Surgery Hospital Universitario de Getafe Carretera de Toledo Km 12 500 28905 Madrid Spain

Department of General and Digestive Surgery Hospital Universitario Rio Hortega Valladolid Spain

Department of General and HPB Surgery and Liver Transplantation University Hospital Ghent Ghent Belgium

Department of Hepatopancreatobiliary Surgery Addenbrooke's Hospital and Department of Surgery University of Cambridge Cambridge UK

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

Hepato Pancreato Biliary Surgery and Liver Transplantation Team Virgen del Rocio University Hospital Seville Spain

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

Moscow Clinical Scientific Center Moscow Russia

Queen Elizabeth Hospital Birmingham Birmingham UK

Citace poskytuje Crossref.org

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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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$a Balakrishnan, Anita $u Department of Hepatopancreatobiliary Surgery, Addenbrooke's Hospital, and Department of Surgery, University of Cambridge, Cambridge, UK
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$a Coppola, Alessandro $u General Surgery Department, Medico University of Rome, Campus Bio, Rome, Italy
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$a Dasari, Bobby V M $u Queen Elizabeth Hospital Birmingham, Birmingham, UK
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$a Feretis, Michail $u Department of Hepatopancreatobiliary Surgery, Addenbrooke's Hospital, Cambridge, UK
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$a Fondevila, Constantino $u Department of General and Digestive Surgery, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, CIBERehd, Spain
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$a Fusai, Giuseppe Kito $u Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK
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$a Garcea, Giuseppe $u Leicester General Hospital, University Hospitals of Leicester, Leicester, UK
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$a Gonzabay, Victor $u Department of General and Digestive Surgery, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, CIBERehd, Spain
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$a Bravo, Miguel Ángel Gómez $u Hepato-Pancreato-Biliary Surgery and Liver Transplantation Team, Virgen del Rocio University Hospital, Seville, Spain
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$a Gorris, Myrte $u Academic Medical Center, Amsterdam, The Netherlands
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$a Hendrikx, Bart $u Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Ghent, Belgium
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$a Hidalgo-Salinas, Camila $u Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK
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$a Kadam, Prashant $u Queen Elizabeth Hospital Birmingham, Birmingham, UK
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$a Karavias, Dimitrios $u Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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$a Kauffmann, Emanuele $u Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
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$a Kourdouli, Amar $u Leicester General Hospital, University Hospitals of Leicester, Leicester, UK
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$a La Vaccara, Vincenzo $u General Surgery Department, Medico University of Rome, Campus Bio, Rome, Italy
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$a van Laarhoven, Stijn $u Department of HPB Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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$a Leighton, James $u Freeman Hospital, Newcastle upon Tyne, UK
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$a Liem, Mike S L $u Division of HPB Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
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$a Machairas, Nikolaos $u Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK
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$a Magouliotis, Dimitris $u Department of Surgery, University Hospital of Larissa, Larissa, Greece
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$a Mahmoud, Adel $u Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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$a Marino, Marco V $u Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
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$a Massani, Marco $u Department of Surgery, Regional Hospital "Ca Foncello"Azienda ULSS2 Marca Trevigiana, Treviso, Italy
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$a Requena, Paola Melgar $u Hospital General Universitario de Alicante, Alicante, Spain
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$a Mentor, Keno $u Freeman Hospital, Newcastle upon Tyne, UK
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$a Napoli, Niccolò $u Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
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$a Nijhuis, Jorieke H T $u Division of HPB Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
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$a Nikov, Andrej $u Department of Surgery, Military University Hospital Prague, Prague, Czech Republic
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$a Nistri, Cristina $u Department of Surgery, Regional Hospital "Ca Foncello"Azienda ULSS2 Marca Trevigiana, Treviso, Italy
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$a Nunes, Victor $u HPB Surgery, Hospital Prof Dr Fernando Fonseca, Amadora, Portugal
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$a Pandanaboyana, Sanjay $u Freeman Hospital, Newcastle upon Tyne, UK
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$a Saborido, Baltasar Pérez $u Department of General and Digestive Surgery, Hospital Universitario Rio Hortega, Valladolid, Spain
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$a Pohnán, Radek $u Department of Surgery, Military University Hospital Prague, Prague, Czech Republic
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$a Popa, Mariuca $u Leicester General Hospital, University Hospitals of Leicester, Leicester, UK
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$a Pérez, Belinda Sánchez $u Hospital Regional de Málaga, Malaga, Spain
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$a Bueno, Francisco Sánchez $u HPB Surgery, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain
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$a Serrablo, Alejandro $u Department of Surgery, Miguel Servet University Hospital, Saragossa, Spain
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$a Serradilla-Martín, Mario $u Department of Surgery, Miguel Servet University Hospital, Saragossa, Spain
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$a Skipworth, James R A $u Department of HPB Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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$a Soreide, Kjetil $u Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
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$a Symeonidis, Dimitris $u Department of Surgery, University Hospital of Larissa, Larissa, Greece
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$a Zacharoulis, Dimitris $u Department of Surgery, University Hospital of Larissa, Larissa, Greece
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$a Zelga, Piotr $u Department of Hepatopancreatobiliary Surgery, Addenbrooke's Hospital, Cambridge, UK
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$a Aliseda, Daniel $u Clínica Universidad De Navarra, Pamplona, Spain
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$a Santiago, María Jesús Castro $u Hospital Universitario Puerta Del Mar, Cadiz, Spain
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$a Mancilla, Carlos Fernández $u Hospital Universitario San Juan De Alicante, Alicante, Spain
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$a Fragua, Raquel Latorre $u Hospital Universitario De Guadalajara, Guadalajara, Spain
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$a Hughes, Daniel Llwyd $u Department of HPB Surgery, Oxford University Hospital NHS Foundation Trust, Oxford, UK
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$a Llorente, Carmen Payá $u Hospital Universitario Doctor Peset, Valencia, Spain
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$a Lesurtel, Mickaël $u Department of Digestive Surgery and Liver Transplantation, Croix Rousse University Hospital, University of Lyon I, Hospices Civils de Lyon, Lyon, France
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$a Gallagher, Tom $u Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland
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$a Ramia, José Manuel $u Hospital General Universitario de Alicante, Alicante, Spain
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