Validating a Simple Scoring System to Predict Malignancy and Invasiveness of Intraductal Papillary Mucinous Neoplasms of the Pancreas
- 2 February 2010
- journal article
- research article
- Published by Wiley in World Journal of Surgery
- Vol. 34 (4), 776-783
- https://doi.org/10.1007/s00268-010-0416-5
Abstract
The objective of the present study was to identify reliable preoperative factors predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm (IPMN) of the pancreas and the effectiveness of a diagnostic scoring system based on these factors. Between August 1994 and December 2007, 204 patients underwent pancreatic resection for IPMN at a single institute. Medical records were reviewed retrospectively, and a new diagnostic scoring system for predicting malignant IPMN preoperatively was designed. Univariate analysis revealed nine significant predictors of both malignant and invasive IPMN: age ≥60 years, history of pancreatitis, presence of mural nodule(s), diameter of main pancreatic duct (MPD) >6 mm, main duct or mixed type, total bilirubin >1.2 mg/dl, CA-19-9 >37 U/ml, tumor location in the pancreatic head, and tumor size >30 mm. Multivariate analysis showed that age, pancreatitis, mural nodule(s), and MPD diameter were independent predictors of invasive IPMN, and that all these parameters, plus elevated carbohydrate antigen-19-9 (CA-19-9), were independent predictors of malignant IPMN. A scoring system based on these five factors, each assigned 1 point, and with a cut-off of 3 points, could predict malignant IPMN with a sensitivity of 50.7% and a specificity of 90.1%. The 5-year survival rates of patients with benign and malignant IPMN were 95.0% and 64.0%, respectively. Our scoring system using five independent factors (age ≥60 years, history of pancreatitis, presence of mural nodule(s), elevated level of CA-19-9, and MPD diameter >6 mm) may be helpful for predicting malignancy and postoperative survival.This publication has 27 references indexed in Scilit:
- Invasive intraductal papillary‐mucinous neoplasm of the pancreas: Comparison with pancreatic ductal adenocarcinomaJournal of Surgical Oncology, 2009
- Preoperative Evaluation of Invasive and Noninvasive Intraductal Papillary-Mucinous Neoplasms of the PancreasPancreas, 2009
- Intraductal papillary mucinous neoplasm of the pancreas: clinical characteristics and treatment outcomes of 118 consecutive patients from a single centerJournal of Hepato-Biliary-Pancreatic Surgery, 2008
- Survival and Prognosis of Invasive Intraductal Papillary Mucinous Neoplasms of the PancreasPancreas, 2008
- Invasive Carcinoma Originating in an Intraductal Papillary Mucinous Neoplasm of the PancreasPancreas, 2006
- Pancreatic head resection with segmental duodenectomy for intraductal papillary mucinous tumors of the pancreasJournal of Gastrointestinal Surgery, 2004
- Intraductal Papillary Mucinous Neoplasms of the PancreasAnnals of Surgery, 2004
- Pancreatic Intraepithelial NeoplasiaThe American Journal of Surgical Pathology, 2001
- Clinicopathological features and treatment of intraductal papillary mucinous tumour of the pancreasBritish Journal of Surgery, 2001
- Intraductal Papillary Mucinous Tumors of the PancreasAnnals of Surgery, 1998