ArticleAnnals of surgical oncology2022
Surgery for Intraductal Papillary Mucinous Neoplasms of the Pancreas: Preoperative Factors Tipping the Scale of Decision-Making.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 23 citations in OpenAlex.
- Improving predictive accuracy for surgical indication of the current management guideline for intraductal papillary mucinous neoplasm of the pancreas via cutoff adjustments.European radiology · 2026Article
- Quantitative MRI of pancreatic parenchyma in intraductal papillary mucinous neoplasm: association with risk stratification based on guideline features.European radiology · 2026Article
- Decision Modeling to Guide Management of Pancreatic IPMNs: Immediate Surgery or Initial Surveillance?Annals of surgical oncology · 2026Article
- Small and Stable Pancreatic Cysts Are Reassuring During Surveillance: Results From the PACYFIC Trial.United European gastroenterology journal · 2025Article
- Endoscopic Ultrasound-Guided Through-the-Needle Biopsy: A Narrative Review of the Technique and Its Emerging Role in Pancreatic Cyst Diagnosis.Diagnostics (Basel, Switzerland) · 2024Review
- Novel Insights into Postoperative Surveillance in Resected Pancreatic Cystic Neoplasms-A Review.Diagnostics (Basel, Switzerland) · 2024Review
- Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple's (RAW) study.BJS open · 2023Article
- Radiomics preoperative-Fistula Risk Score (RAD-FRS) for pancreatoduodenectomy: development and external validation.BJS open · 2023Article
- Article
- Comment on "Surgery for Intraductal Papillary Mucinous Neoplasms of the Pancreas: Preoperative Factors Tipping the Scale of Decision-Making".Annals of surgical oncology · 2022Article
- Modern aspects of the management of pancreatic intraductal papillary mucinous neoplasms: a narrative review.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologieReview
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDecision-making in intraductal papillary mucinous neoplasms (IPMNs) of the pancreas depends on scaling the risk of malignancy with the surgical burden of a pancreatectomy. This study aimed to develop a preoperative, disease-specific tool to predict surgical morbidity for IPMNs.
methodsBased on preoperative variables of resected IPMNs at two high-volume institutions, classification tree analysis was applied to derive a predictive model identifying the risk factors for major morbidity (Clavien-Dindo ≥3) and postoperative pancreatic insufficiency.
resultsAmong 524 patients, 289 (55.2%) underwent pancreaticoduodenectomy (PD), 144 (27.5%) underwent distal pancreatectomy (DP), and 91 (17.4%) underwent total pancreatectomy (TP) for main-duct (18.7%), branch-duct (12.6%), or mixed-type (68.7%) IPMN. For 98 (18.7%) of the patients, major morbidity developed. The classification tree distinguished different probabilities of major complications based on the type of surgery (area under the surve [AUC] 0.70; 95% confidence interval [CI], 0.63-0.77). Among the DP patients, the presence of preoperative diabetes identified two risk classes with respective probabilities of 5% and 25% for the development of major morbidity, whereas among the PD/TP patients, three different classes with respective probabilities of 15%, 20%, and 36% were identified according to age and body mass index (BMI). Overall, history of diabetes, age, and cyst size segregated three different risk classes for new-onset/worsening diabetes.
conclusionsIn presumed IPMNs, the disease-specific risk of major morbidity and pancreatic insufficiency can be determined in the preoperative setting and used to personalize the possible surgical indication. Age and overweight status in case of PD/TP and diabetes in case of DP tip the scale toward less aggressive clinical management in the absence of features suggestive for malignancy.
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