A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort.Methods An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included.Results A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score >= 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%.Conclusion Patients with a Shin score <= 1 should undergo surveillance, while patients with a score = 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.

A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation / Manuel-Vázquez, Alba; Balakrishnan, Anita; Agami, Paul; Andersson, Bodil; Berrevoet, Frederik; Besselink, Marc G; Boggi, Ugo; Caputo, Damiano; Carabias, Alberto; Carrion-Alvarez, Lucia; Franco, Carmen Cepeda; Coppola, Alessandro; Dasari, Bobby V M; Diaz-Mercedes, Sherley; Feretis, Michail; Fondevila, Constantino; Fusai, Giuseppe Kito; Garcea, Giuseppe; Gonzabay, Victor; Bravo, Miguel Ángel Gómez; Gorris, Myrte; Hendrikx, Bart; Hidalgo-Salinas, Camila; Kadam, Prashant; Karavias, Dimitrios; Kauffmann, Emanuele; Kourdouli, Amar; La Vaccara, Vincenzo; van Laarhoven, Stijn; Leighton, James; Liem, Mike S L; Machairas, Nikolaos; Magouliotis, Dimitris; Mahmoud, Adel; Marino, Marco V; Massani, Marco; Requena, Paola Melgar; Mentor, Keno; Napoli, Niccolò; Nijhuis, Jorieke H T; Nikov, Andrej; Nistri, Cristina; Nunes, Victor; Ruiz, Eduardo Ortiz; Pandanaboyana, Sanjay; Saborido, Baltasar Pérez; Pohnán, Radek; Popa, Mariuca; Pérez, Belinda Sánchez; Bueno, Francisco Sánchez; Serrablo, Alejandro; Serradilla-Martín, Mario; Skipworth, James R A; Soreide, Kjetil; Symeonidis, Dimitris; Zacharoulis, Dimitris; Zelga, Piotr; Aliseda, Daniel; Santiago, María Jesús Castro; Mancilla, Carlos Fernández; Fragua, Raquel Latorre; Hughes, Daniel Llwyd; Llorente, Carmen Payá; Lesurtel, Mickaël; Gallagher, Tom; Ramia, José Manuel. - In: LANGENBECK'S ARCHIVES OF SURGERY. - ISSN 1435-2451. - 407:8(2022), pp. 3447-3455. [10.1007/s00423-022-02687-2]

A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation

Coppola, Alessandro;
2022

Abstract

A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort.Methods An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included.Results A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score >= 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%.Conclusion Patients with a Shin score <= 1 should undergo surveillance, while patients with a score = 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.
2022
intraductal papillary mucinous neoplasm; malignancy; pancreatic neoplasm; preoperative diagnosis; score
01 Pubblicazione su rivista::01a Articolo in rivista
A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation / Manuel-Vázquez, Alba; Balakrishnan, Anita; Agami, Paul; Andersson, Bodil; Berrevoet, Frederik; Besselink, Marc G; Boggi, Ugo; Caputo, Damiano; Carabias, Alberto; Carrion-Alvarez, Lucia; Franco, Carmen Cepeda; Coppola, Alessandro; Dasari, Bobby V M; Diaz-Mercedes, Sherley; Feretis, Michail; Fondevila, Constantino; Fusai, Giuseppe Kito; Garcea, Giuseppe; Gonzabay, Victor; Bravo, Miguel Ángel Gómez; Gorris, Myrte; Hendrikx, Bart; Hidalgo-Salinas, Camila; Kadam, Prashant; Karavias, Dimitrios; Kauffmann, Emanuele; Kourdouli, Amar; La Vaccara, Vincenzo; van Laarhoven, Stijn; Leighton, James; Liem, Mike S L; Machairas, Nikolaos; Magouliotis, Dimitris; Mahmoud, Adel; Marino, Marco V; Massani, Marco; Requena, Paola Melgar; Mentor, Keno; Napoli, Niccolò; Nijhuis, Jorieke H T; Nikov, Andrej; Nistri, Cristina; Nunes, Victor; Ruiz, Eduardo Ortiz; Pandanaboyana, Sanjay; Saborido, Baltasar Pérez; Pohnán, Radek; Popa, Mariuca; Pérez, Belinda Sánchez; Bueno, Francisco Sánchez; Serrablo, Alejandro; Serradilla-Martín, Mario; Skipworth, James R A; Soreide, Kjetil; Symeonidis, Dimitris; Zacharoulis, Dimitris; Zelga, Piotr; Aliseda, Daniel; Santiago, María Jesús Castro; Mancilla, Carlos Fernández; Fragua, Raquel Latorre; Hughes, Daniel Llwyd; Llorente, Carmen Payá; Lesurtel, Mickaël; Gallagher, Tom; Ramia, José Manuel. - In: LANGENBECK'S ARCHIVES OF SURGERY. - ISSN 1435-2451. - 407:8(2022), pp. 3447-3455. [10.1007/s00423-022-02687-2]
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