ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2015
Current recommendations for surveillance and surgery of intraductal papillary mucinous neoplasms may overlook some patients with cancer.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Imaging Features for Predicting High-Grade Dysplasia or Malignancy in Branch Duct Type Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Systematic Review and Meta-Analysis.Annals of surgical oncology · 2022Pooled it
- Guideline
- ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts.The American journal of gastroenterology · 2018Guideline
- Prediction of main pancreatic duct involvement in intraductal papillary mucinous neoplasms on magnetic resonance imaging.Abdominal radiology (New York) · 2025Article
- Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study.Diagnostics (Basel, Switzerland) · 2025Article
- The Hong Kong consensus recommendations on the diagnosis and management of pancreatic cystic lesions.Hepatobiliary surgery and nutrition · 2023Review
- Branch duct-intraductal papillary mucinous neoplasms (BD-IPMNs): an MRI-based radiomic model to determine the malignant degeneration potential.La Radiologia medica · 2023Article
- Static and DynamicJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2023Article
- Limitations and prospects in the management of IPMN: a retrospective, single-center observational study.BMC surgery · 2023Observational
- Incidence of pancreatic cancer during long-term follow-up in patients with incidental pancreatic cysts smaller than 2 cm.European radiology · 2022Article
- Article
- Article
- Proteome heterogeneity and malignancy detection in pancreatic cyst fluids.Clinical and translational medicine · 2021Article
- Comparison of Preoperative Evaluation with the Pathological Report in Intraductal Papillary Mucinous Neoplasms: A Single-Center Experience.Journal of clinical medicine · 2021Article
- Article
- Article
- Pre-operative nomogram predicting malignant potential in the patients with intraductal papillary mucinous neoplasm of the pancreas: focused on imaging features based on revised international guideline.European radiology · 2020Article
- Surgical strategy for intraductal papillary mucinous neoplasms of the pancreas.Surgery today · 2020Review
- Pancreatic Cysts in the Elderly.Current treatment options in gastroenterology · 2019Review
- Diagnosis and management of intraductal papillary mucinous neoplasms of the pancreas.Acta bio-medica : Atenei Parmensis · 2018Review
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe 2012 Sendai Criteria recommend that patients with 3 cm or larger branch duct intraductal papillary mucinous neoplasms (BD-IPMN) without any additional "worrisome features" or "high-risk stigmata" may undergo close observation. Furthermore, endoscopic ultrasound (EUS) is not recommended for BD-IPMN <2 cm. These changes have generated concern among physicians treating patients with pancreatic diseases. The purposes of this study were to (i) apply the new Sendai guidelines to our institution's surgically resected BD-IPMN and (ii) reevaluate cyst size cutoffs in identifying patients with lesions harboring high-grade dysplasia or invasive cancer.
methodsWe retrospectively reviewed 150 patients at a university medical center with preoperatively diagnosed and pathologically confirmed IPMNs. Sixty-six patients had BD-IPMN. Pathologic grade was dichotomized into low-grade (low or intermediate grade dysplasia) or high-grade/invasive (high-grade dysplasia or invasive cancers). Fisher's exact test, chi-square test, student's t test, linear regression, and receiver operating characteristic (ROC) analyses were performed.
resultsThe median BD-IPMN size on imaging was 2.4 cm (interquartile range 1.5-3.0). Fifty-one (77 %) low-grade and 15 (23 %) high-grade/invasive BD-IPMN were identified. ROC analysis demonstrated that cyst size on preoperative imaging is a reasonable predictor of grade with an area under the curve of 0.691. Two-thirds of high-grade/invasive BD-IPMN were <3 cm (n = 10). Compared to a cutoff of 3, 2 cm was associated with higher sensitivity (73.3 vs. 33.3 %) and negative predictive value (83.3 vs. 80 %, NPV) for high-grade/invasive BD-IPMN. Mural nodules on endoscopic ultrasound (EUS) or atypical cells on endoscopic ultrasound-fine needle aspiration (EUS-FNA) were identified in all cysts <2 and only 50 % of those <3 cm. Forty percent of cysts >3 cm were removed based on size alone. DISCUSSION/
conclusionsOur results suggest that "larger" size on noninvasive imaging can indicate high-grade/invasive cysts, and EUS-FNA may help identify "smaller" cysts with high-grade/invasive pathology.
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