A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation
Garcea, Giuseppe Popa, Mariuca
Garcea, Giuseppe
Popa, Mariuca
Abstract
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.
MIDER Authors
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Date
2022-10-06
Type
Article
Subject
Intraductal papillary mucinous neoplasm, Malignancy, Pancreatic neoplasm, Preoperative diagnosis, Score
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Citation
Manuel-Vázquez, A., Balakrishnan, A., Agami, P., Andersson, B., Berrevoet, F., Besselink, M. G., Boggi, U., Caputo, D., Carabias, A., Carrion-Alvarez, L., Franco, C. C., Coppola, A., Dasari, B. V. M., Diaz-Mercedes, S., Feretis, M., Fondevila, C., Fusai, G. K., Garcea, G., Gonzabay, V., Bravo, M. Á. G., … on behalf the Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) (2022). A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation. Langenbeck's archives of surgery, 407(8), 3447–3455. https://doi.org/10.1007/s00423-022-02687-2