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Observational Study
. 2022 Dec;407(8):3447-3455.
doi: 10.1007/s00423-022-02687-2. Epub 2022 Oct 6.

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

Alba Manuel-Vázquez  1 , Anita Balakrishnan  2 , Paul Agami  3 , Bodil Andersson  4 , Frederik Berrevoet  5 , Marc G Besselink  6 , Ugo Boggi  7 , Damiano Caputo  8 , Alberto Carabias  9 , Lucia Carrion-Alvarez  10 , Carmen Cepeda Franco  11 , Alessandro Coppola  8 , Bobby V M Dasari  12 , Sherley Diaz-Mercedes  13 , Michail Feretis  14 , Constantino Fondevila  15 , Giuseppe Kito Fusai  16 , Giuseppe Garcea  17 , Victor Gonzabay  15 , Miguel Ángel Gómez Bravo  11 , Myrte Gorris  6 , Bart Hendrikx  5 , Camila Hidalgo-Salinas  16 , Prashant Kadam  12 , Dimitrios Karavias  18 , Emanuele Kauffmann  7 , Amar Kourdouli  17 , Vincenzo La Vaccara  8 , Stijn van Laarhoven  19 , James Leighton  20 , Mike S L Liem  21 , Nikolaos Machairas  16 , Dimitris Magouliotis  22 , Adel Mahmoud  18 , Marco V Marino  23 , Marco Massani  24 , Paola Melgar Requena  25 , Keno Mentor  20 , Niccolò Napoli  7 , Jorieke H T Nijhuis  21 , Andrej Nikov  26 , Cristina Nistri  24 , Victor Nunes  27 , Eduardo Ortiz Ruiz  28 , Sanjay Pandanaboyana  20 , Baltasar Pérez Saborido  29 , Radek Pohnán  26 , Mariuca Popa  17 , Belinda Sánchez Pérez  30 , Francisco Sánchez Bueno  31 , Alejandro Serrablo  32 , Mario Serradilla-Martín  32 , James R A Skipworth  19 , Kjetil Soreide  33 , Dimitris Symeonidis  22 , Dimitris Zacharoulis  22 , Piotr Zelga  14 , Daniel Aliseda  34 , María Jesús Castro Santiago  35 , Carlos Fernández Mancilla  36 , Raquel Latorre Fragua  37 , Daniel Llwyd Hughes  38 , Carmen Payá Llorente  39 , Mickaël Lesurtel  40 , Tom Gallagher  41 , José Manuel Ramia  25 ; on behalf the Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA)
Affiliations
Observational Study

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

Alba Manuel-Vázquez et al. Langenbecks Arch Surg. 2022 Dec.

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.

Keywords: Intraductal papillary mucinous neoplasm; Malignancy; Pancreatic neoplasm; Preoperative diagnosis; Score.

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References

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