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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.
Affiliation
  • Manuel-Vázquez A; Department of General and Digestive Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12, 500, 28905, Madrid, Spain. alba_manuel_vazquez@hotmail.com.
  • Balakrishnan A; Department of Hepatopancreatobiliary Surgery, Addenbrooke's Hospital, and Department of Surgery, University of Cambridge, Cambridge, UK.
  • Agami P; Moscow Clinical Scientific Center, Moscow, Russia.
  • Andersson B; Department of Clinical Sciences Lund, Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
  • Berrevoet F; Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Ghent, Belgium.
  • Besselink MG; Academic Medical Center, Amsterdam, The Netherlands.
  • Boggi U; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Caputo D; General Surgery Department, Medico University of Rome, Campus Bio, Rome, Italy.
  • Carabias A; Department of General and Digestive Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12, 500, 28905, Madrid, Spain.
  • Carrion-Alvarez L; General Surgery Department, HPB Unit Fuenlabrada University Hospital, Madrid, Spain.
  • Franco CC; Hepato-Pancreato-Biliary Surgery and Liver Transplantation Team, Virgen del Rocio University Hospital, Seville, Spain.
  • Coppola A; General Surgery Department, Medico University of Rome, Campus Bio, Rome, Italy.
  • Dasari BVM; Queen Elizabeth Hospital Birmingham, Birmingham, UK.
  • Diaz-Mercedes S; Department of Pathology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
  • Feretis M; Department of Hepatopancreatobiliary Surgery, Addenbrooke's Hospital, Cambridge, UK.
  • Fondevila C; Department of General and Digestive Surgery, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, CIBERehd, Spain.
  • Fusai GK; Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.
  • Garcea G; Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
  • Gonzabay V; Department of General and Digestive Surgery, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, CIBERehd, Spain.
  • Bravo MÁG; Hepato-Pancreato-Biliary Surgery and Liver Transplantation Team, Virgen del Rocio University Hospital, Seville, Spain.
  • Gorris M; Academic Medical Center, Amsterdam, The Netherlands.
  • Hendrikx B; Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Ghent, Belgium.
  • Hidalgo-Salinas C; Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.
  • Kadam P; Queen Elizabeth Hospital Birmingham, Birmingham, UK.
  • Karavias D; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Kauffmann E; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Kourdouli A; Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
  • La Vaccara V; General Surgery Department, Medico University of Rome, Campus Bio, Rome, Italy.
  • van Laarhoven S; Department of HPB Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
  • Leighton J; Freeman Hospital, Newcastle upon Tyne, UK.
  • Liem MSL; Division of HPB Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
  • Machairas N; Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.
  • Magouliotis D; Department of Surgery, University Hospital of Larissa, Larissa, Greece.
  • Mahmoud A; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Marino MV; Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
  • Massani M; Department of Surgery, Regional Hospital "Ca Foncello"Azienda ULSS2 Marca Trevigiana, Treviso, Italy.
  • Requena PM; Hospital General Universitario de Alicante, Alicante, Spain.
  • Mentor K; Freeman Hospital, Newcastle upon Tyne, UK.
  • Napoli N; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Nijhuis JHT; Division of HPB Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
  • Nikov A; Department of Surgery, Military University Hospital Prague, Prague, Czech Republic.
  • Nistri C; Department of Surgery, Regional Hospital "Ca Foncello"Azienda ULSS2 Marca Trevigiana, Treviso, Italy.
  • Nunes V; HPB Surgery, Hospital Prof Dr Fernando Fonseca, Amadora, Portugal.
  • Ruiz EO; Department of Pathology, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain.
  • Pandanaboyana S; Freeman Hospital, Newcastle upon Tyne, UK.
  • Saborido BP; Department of General and Digestive Surgery, Hospital Universitario Rio Hortega, Valladolid, Spain.
  • Pohnán R; Department of Surgery, Military University Hospital Prague, Prague, Czech Republic.
  • Popa M; Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
  • Pérez BS; Hospital Regional de Málaga, Malaga, Spain.
  • Bueno FS; HPB Surgery, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain.
Langenbecks Arch Surg ; 407(8): 3447-3455, 2022 Dec.
Article in En | MEDLINE | ID: mdl-36198881
ABSTRACT

PURPOSE:

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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreatic Neoplasms / Adenocarcinoma, Mucinous / Carcinoma, Pancreatic Ductal / Pancreatic Intraductal Neoplasms Type of study: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Langenbecks Arch Surg Year: 2022 Document type: Article Affiliation country: Spain
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreatic Neoplasms / Adenocarcinoma, Mucinous / Carcinoma, Pancreatic Ductal / Pancreatic Intraductal Neoplasms Type of study: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Langenbecks Arch Surg Year: 2022 Document type: Article Affiliation country: Spain