International consensus guidelines parameters for the prediction of malignancy in intraductal papillary mucinous neoplasm are not properly weighted and are not cumulative

Alexandra M. Roch, Eugene P. Ceppa, John DeWitt, Mohammad A. Al-Haddad, Michael House, Attila Nakeeb, C. Schmidt

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: The International Consensus Guidelines (ICG) stratify risk for malignancy in patients with intraductal papillary mucinous neoplasm (IPMN) into three progressive categories according to whether patients show 'no criteria', 'worrisome features' (WFs) or 'high-risk stigmata' (HRS). Objectives: This study was conducted to test the hypothesis that type (clinical versus radiological) and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN. Methods: A retrospective review of a prospectively maintained database of patients who underwent surgical resection for IPMN at a single, university-based medical centre during 1992-2012 was performed. Differences that achieved a P-value of <0.05 were considered significant. Results: Of 362 patients, 340 were eligible for entry into the study and were categorized as demonstrating no criteria (n = 70), WFs (n = 185) or HRS (n = 85). Patients in the WFs group had higher rates of malignant and invasive IPMN than those in the no-criteria group [26.5% versus 4.3% (P < 0.0001) and 15.7% versus 4.3% (P = 0.02), respectively]. Patients in the HRS group had higher rates of malignant and invasive IPMN than those in the WFs group [56.5% versus 26.5% (P = 0.0001) and 42.4% versus 15.7% (P = 0.0001), respectively]. When radiological parameters only were considered for WFs versus HRS, no difference was found in rates of malignant or invasive IPMN. By contrast, when clinical parameters only were considered, patients in the HRS group had higher rates of malignant or invasive IPMN [66.7% versus 8.1% (P = 0.04) and 66.7% versus 2.7% (P = 0.01), respectively]. There was no stepwise increase in rates of malignant or invasive IPMN with the number of WFs. However, patients with only one WF had a lower risk for malignancy than patients with two or more WFs. Conclusions: The type and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN.

Original languageEnglish
Pages (from-to)929-935
Number of pages7
JournalHPB
Volume16
Issue number10
DOIs
StatePublished - 2014

Fingerprint

Guidelines
Christianity
Neoplasms
Weights and Measures
Databases

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

International consensus guidelines parameters for the prediction of malignancy in intraductal papillary mucinous neoplasm are not properly weighted and are not cumulative. / Roch, Alexandra M.; Ceppa, Eugene P.; DeWitt, John; Al-Haddad, Mohammad A.; House, Michael; Nakeeb, Attila; Schmidt, C.

In: HPB, Vol. 16, No. 10, 2014, p. 929-935.

Research output: Contribution to journalArticle

@article{f77696a00ffa40e8ac352582929b2bfc,
title = "International consensus guidelines parameters for the prediction of malignancy in intraductal papillary mucinous neoplasm are not properly weighted and are not cumulative",
abstract = "Background: The International Consensus Guidelines (ICG) stratify risk for malignancy in patients with intraductal papillary mucinous neoplasm (IPMN) into three progressive categories according to whether patients show 'no criteria', 'worrisome features' (WFs) or 'high-risk stigmata' (HRS). Objectives: This study was conducted to test the hypothesis that type (clinical versus radiological) and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN. Methods: A retrospective review of a prospectively maintained database of patients who underwent surgical resection for IPMN at a single, university-based medical centre during 1992-2012 was performed. Differences that achieved a P-value of <0.05 were considered significant. Results: Of 362 patients, 340 were eligible for entry into the study and were categorized as demonstrating no criteria (n = 70), WFs (n = 185) or HRS (n = 85). Patients in the WFs group had higher rates of malignant and invasive IPMN than those in the no-criteria group [26.5{\%} versus 4.3{\%} (P < 0.0001) and 15.7{\%} versus 4.3{\%} (P = 0.02), respectively]. Patients in the HRS group had higher rates of malignant and invasive IPMN than those in the WFs group [56.5{\%} versus 26.5{\%} (P = 0.0001) and 42.4{\%} versus 15.7{\%} (P = 0.0001), respectively]. When radiological parameters only were considered for WFs versus HRS, no difference was found in rates of malignant or invasive IPMN. By contrast, when clinical parameters only were considered, patients in the HRS group had higher rates of malignant or invasive IPMN [66.7{\%} versus 8.1{\%} (P = 0.04) and 66.7{\%} versus 2.7{\%} (P = 0.01), respectively]. There was no stepwise increase in rates of malignant or invasive IPMN with the number of WFs. However, patients with only one WF had a lower risk for malignancy than patients with two or more WFs. Conclusions: The type and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN.",
author = "Roch, {Alexandra M.} and Ceppa, {Eugene P.} and John DeWitt and Al-Haddad, {Mohammad A.} and Michael House and Attila Nakeeb and C. Schmidt",
year = "2014",
doi = "10.1111/hpb.12305",
language = "English",
volume = "16",
pages = "929--935",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",
number = "10",

}

TY - JOUR

T1 - International consensus guidelines parameters for the prediction of malignancy in intraductal papillary mucinous neoplasm are not properly weighted and are not cumulative

AU - Roch, Alexandra M.

AU - Ceppa, Eugene P.

AU - DeWitt, John

AU - Al-Haddad, Mohammad A.

AU - House, Michael

AU - Nakeeb, Attila

AU - Schmidt, C.

PY - 2014

Y1 - 2014

N2 - Background: The International Consensus Guidelines (ICG) stratify risk for malignancy in patients with intraductal papillary mucinous neoplasm (IPMN) into three progressive categories according to whether patients show 'no criteria', 'worrisome features' (WFs) or 'high-risk stigmata' (HRS). Objectives: This study was conducted to test the hypothesis that type (clinical versus radiological) and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN. Methods: A retrospective review of a prospectively maintained database of patients who underwent surgical resection for IPMN at a single, university-based medical centre during 1992-2012 was performed. Differences that achieved a P-value of <0.05 were considered significant. Results: Of 362 patients, 340 were eligible for entry into the study and were categorized as demonstrating no criteria (n = 70), WFs (n = 185) or HRS (n = 85). Patients in the WFs group had higher rates of malignant and invasive IPMN than those in the no-criteria group [26.5% versus 4.3% (P < 0.0001) and 15.7% versus 4.3% (P = 0.02), respectively]. Patients in the HRS group had higher rates of malignant and invasive IPMN than those in the WFs group [56.5% versus 26.5% (P = 0.0001) and 42.4% versus 15.7% (P = 0.0001), respectively]. When radiological parameters only were considered for WFs versus HRS, no difference was found in rates of malignant or invasive IPMN. By contrast, when clinical parameters only were considered, patients in the HRS group had higher rates of malignant or invasive IPMN [66.7% versus 8.1% (P = 0.04) and 66.7% versus 2.7% (P = 0.01), respectively]. There was no stepwise increase in rates of malignant or invasive IPMN with the number of WFs. However, patients with only one WF had a lower risk for malignancy than patients with two or more WFs. Conclusions: The type and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN.

AB - Background: The International Consensus Guidelines (ICG) stratify risk for malignancy in patients with intraductal papillary mucinous neoplasm (IPMN) into three progressive categories according to whether patients show 'no criteria', 'worrisome features' (WFs) or 'high-risk stigmata' (HRS). Objectives: This study was conducted to test the hypothesis that type (clinical versus radiological) and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN. Methods: A retrospective review of a prospectively maintained database of patients who underwent surgical resection for IPMN at a single, university-based medical centre during 1992-2012 was performed. Differences that achieved a P-value of <0.05 were considered significant. Results: Of 362 patients, 340 were eligible for entry into the study and were categorized as demonstrating no criteria (n = 70), WFs (n = 185) or HRS (n = 85). Patients in the WFs group had higher rates of malignant and invasive IPMN than those in the no-criteria group [26.5% versus 4.3% (P < 0.0001) and 15.7% versus 4.3% (P = 0.02), respectively]. Patients in the HRS group had higher rates of malignant and invasive IPMN than those in the WFs group [56.5% versus 26.5% (P = 0.0001) and 42.4% versus 15.7% (P = 0.0001), respectively]. When radiological parameters only were considered for WFs versus HRS, no difference was found in rates of malignant or invasive IPMN. By contrast, when clinical parameters only were considered, patients in the HRS group had higher rates of malignant or invasive IPMN [66.7% versus 8.1% (P = 0.04) and 66.7% versus 2.7% (P = 0.01), respectively]. There was no stepwise increase in rates of malignant or invasive IPMN with the number of WFs. However, patients with only one WF had a lower risk for malignancy than patients with two or more WFs. Conclusions: The type and quantity of ICG WFs and HRS carry unequal weight and are not cumulative in the prediction of risk for malignancy or invasiveness in IPMN.

UR - http://www.scopus.com/inward/record.url?scp=84926296871&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84926296871&partnerID=8YFLogxK

U2 - 10.1111/hpb.12305

DO - 10.1111/hpb.12305

M3 - Article

C2 - 25077378

AN - SCOPUS:84926296871

VL - 16

SP - 929

EP - 935

JO - HPB

JF - HPB

SN - 1365-182X

IS - 10

ER -