A multimodality test to guide the management of patients with a pancreatic cyst

Simeon Springer, David L. Masica, Marco Dal Molin, Christopher Douville, Christopher J. Thoburn, Bahman Afsari, Lu Li, Joshua D. Cohen, Elizabeth Thompson, Peter J. Allen, David S. Klimstra, Mark A. Schattner, C. Max Schmidt, Michele Yip-Schneider, Rachel E. Simpson, Carlos Fernandez Del Castillo, Mari Mino-Kenudson, William Brugge, Randall E. Brand, Aatur D. SinghiAldo Scarpa, Rita Lawlor, Roberto Salvia, Giuseppe Zamboni, Seung Mo Hong, Dae Wook Hwang, Jin Young Jang, Wooil Kwon, Niall Swan, Justin Geoghegan, Massimo Falconi, Stefano Crippa, Claudio Doglioni, Jorge Paulino, Richard D. Schulick, Barish H. Edil, Walter Park, Shinichi Yachida, Susumu Hijioka, Jeanin Van Hooft, Jin He, Matthew J. Weiss, Richard Burkhart, Martin Makary, Marcia I. Canto, Michael G. Goggins, Janine Ptak, Lisa Dobbyn, Joy Schaefer, Natalie Sillman, Maria Popoli, Alison P. Klein, Cristian Tomasetti, Rachel Karchin, Nickolas Papadopoulos, Kenneth W. Kinzler, Bert Vogelstein, Christopher L. Wolfgang, Ralph H. Hruban, Anne Marie Lennon

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Pancreatic cysts are common and often pose a management dilemma, because some cysts are precancerous, whereas others have little risk of developing into invasive cancers. We used supervised machine learning techniques to develop a comprehensive test, CompCyst, to guide the management of patients with pancreatic cysts. The test is based on selected clinical features, imaging characteristics, and cyst fluid genetic and biochemical markers. Using data from 436 patients with pancreatic cysts, we trained CompCyst to classify patients as those who required surgery, those who should be routinely monitored, and those who did not require further surveillance. We then tested CompCyst in an independent cohort of 426 patients, with histopathology used as the gold standard. We found that clinical management informed by the CompCyst test was more accurate than the management dictated by conventional clinical and imaging criteria alone. Application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices.

Original languageEnglish (US)
Article numbereaav4772
JournalScience translational medicine
Volume11
Issue number501
DOIs
StatePublished - Jul 17 2019

ASJC Scopus subject areas

  • Medicine(all)

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