Surgical overtreatment of pancreatic intraductal papillary mucinous neoplasms: Do the 2017 International Consensus Guidelines improve clinical decision making?

Surgery
Jeremy M SharibKimberly S Kirkwood

Abstract

Significant overtreatment of intraductal papillary mucinous neoplasms can be attributed to low specificity of the current International Consensus Guidelines as well as nonconformity with the guidelines. We compare the ability of the 2012 and revised 2017 intraductal papillary mucinous neoplasms International Consensus Guidelines to predict high-grade dysplasia/invasive cancer and to determine the preoperative variables that predict resection of benign or low-grade dysplasia in tertiary care centers. Clinical, radiographic, and pathologic data for resected intraductal papillary mucinous neoplasms at 3 high-volume National Cancer Institute Cancer Centers were reviewed and the 2012 and 2017 consensus criteria were retrospectively applied. When International Consensus Guidelines were not met, clinical decision analysis was used to determine the primary indication for resection. Logistic regression identified variables associated with pathologic grade. Records for a total of 251 patients were reviewed, 129 of whom (52%) had low-grade dysplasia. The revised 2017 International Consensus Guidelines had high sensitivity (98.4%) and negative predicted value (96.1%), and all high-risk stigmata predicted high-grade dysplasia/invasive cance...Continue Reading

Citations

Aug 7, 2019·JAMA : the Journal of the American Medical Association·UNKNOWN US Preventive Services Task ForceJohn B Wong
Feb 9, 2021·Cancer Metastasis Reviews·Michaël NoëRalph H Hruban
Mar 21, 2021·Abdominal Radiology·Justin G YoonSree Harsha Tirumani
Apr 4, 2021·International Journal of Molecular Sciences·Natsuhiko KuratomiNobuyuki Enomoto
Jun 25, 2021·Journal of the American College of Surgeons·Michele T Yip-SchneiderC Max Schmidt

❮ Previous
Next ❯

Related Concepts

Related Feeds

Astrocytes

Astrocytes are glial cells that support the blood-brain barrier, facilitate neurotransmission, provide nutrients to neurons, and help repair damaged nervous tissues. Here is the latest research.