Evaluation of the International Consensus Guidelines for the Surgical Resection of Intraductal Papillary Mucinous Neoplasms
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International consensus guidelines for intraductal papillary mucinous neoplasms (IPMNs) were revised in 2012.
We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications.
Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value.
The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64.3 vs. 31.0%). Moreover, the accuracy for high-grade dysplasia was also increased (48.6 vs. 77.1%). When the main pancreatic duct (MPD) size ≥8 mm was substituted for MPD size ≥10 mm in the 2012 guidelines, the accuracy for high-grade dysplasia was 80.0%.
The 2012 guidelines exhibited increased diagnostic accuracy for invasive IPMN. It is important to consider surgical resection prior to invasive carcinoma, and high-risk stigmata might be a useful diagnostic criterion. Furthermore, MPD size ≥8 mm may be predictive of high-grade dysplasia.
KeywordsIntraductal papillary mucinous neoplasm IPMN Pancreas Guidelines Surgical indication
We thank Ms. Yuki Saka and Tomoko Ubukata for their excellent assistance.
Compliance with ethical standards
Conflict of interest
There was no significant financial support for this work that could have influenced its outcome.
The study was approved by the Ethics Committee of the hospital, and all clinical samples were used in accordance with institutional guidelines and the Declaration of Helsinki after obtaining signed informed consent from all participants.
- 7.Goh BK, Thng CH, Tan DM, et al. Evaluation of the Sendai and 2012 International Consensus Guidelines based on cross-sectional imaging findings performed for the initial triage of mucinous cystic lesions of the pancreas: a single institution experience with 114 surgically treated patients. Am J Surg. 2014;208:202–209.CrossRefPubMedGoogle Scholar
- 14.Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO Classification of Tumours of the Digestive System. 4th ed. Lyon: International Agency for Research on Cancer; 2010.Google Scholar
- 19.Kang MJ, Jang JY, Lee S, et al. Clinicopathological meaning of size of main-duct dilatation in intraductal papillary mucinous neoplasm of pancreas: proposal of a simplified morphological classification based on the investigation on the size of main pancreatic duct. World J Surg. 2015;39:2006–2013.CrossRefPubMedGoogle Scholar