scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Branch duct intraductal papillary mucinous neoplasms: does cyst size change the tip of the scale? A critical analysis of the revised international consensus guidelines in a large single-institutional series.

TL;DR: Expectant management of BD-IPMN following the old guidelines is safe, whereas caution is advised for larger lesions, even in the absence of worrisome features.
Abstract: Objective:The aim of this study was to critically analyze the safety of the revised guidelines, with focus on cyst size and worrisome features in the management of BD-IPMN.Background:The Sendai guidelines for management of branch duct (BD) intraductal papillary mucinous neoplasm (IPMN) espouse safet
Citations
More filters
Journal ArticleDOI
TL;DR: The working group has revised the guidelines regarding prediction of invasive carcinoma and high-grade dysplasia, surveillance, and postoperative follow-up of IPMN and includes updated information and recommendations based on the current understanding.

1,104 citations


Cites background or methods from "Branch duct intraductal papillary m..."

  • ...While it has been reported that ~10% “malignant” BD IPMNs have no mural nodules, nearly all of these ca ses were HGD [19, 81, 108], and thus invasive cancer is exceptional in the absence of a mural nod ule within the cyst....

    [...]

  • ...The usefulness of the previous Fukuoka consensus cr iteria for resections has been validated by many reports [81-87, 94-102]....

    [...]

  • ...Although cyst size is associated with an increased risk of harboring HGD and invasive cancer, there is no cut-off to quantify the risk [85, 120], and i n general, cyst size alone is not an appropriate parameter to indicate surgery given its poor predic tive value for invasive carcinoma and HGD [19, 76, 81, 121-123]....

    [...]

Journal ArticleDOI
Marco Del Chiaro, Marc G. Besselink1, Lianne Scholten, Marco J. Bruno, Djuna L. Cahen, Thomas M. Gress, Jeanin E. van Hooft, Markus M. Lerch, Julia Mayerle, Thilo Hackert, Sohei Satoi, Alessandro Zerbi, David Cunningham, Claudio De Angelis, Marc Giovanni, Enrique de-Madaria, Péter Hegyi, Jonas Rosendahl, Helmut Friess, Riccardo Manfredi, Philippe Lévy, Francisco X. Real, Alain Sauvanet, Mohammed Abu Hilal, Giovanni Marchegiani, Irene Esposito, Paula Ghaneh, Marc R. W. Engelbrecht, Paul Fockens, Nadine C.M. van Huijgevoort, Christopher L. Wolfgang, Claudio Bassi, Natalya Gubergrits, Caroline S. Verbeke, Günter Klöppel, Aldo Scarpa, Giuseppe Zamboni, Anne Marie Lennon, Malin Sund, Nikolaos Kartalis, Lars Grenacher, Massimo Falconi1, Urban Arnelo, Kostantin V. Kopchak, Kofi Oppong, Colin J. McKay, Truls Hauge, Kevin C. Conlon, Mustapha Adham, Güralp O. Ceyhan, Roberto Salvia, Christos Dervenis, Peter J. Allen, François Paye, Detlef K. Bartsch, Matthias Löhr, Massimiliano Mutignani, Johanna Laukkarinen, Richard D. Schulick, Roberto Valente, Thomas Seufferlein, Gabriele Capurso, Ajith K. Siriwardena, John P. Neoptolemos, Aldis Pukitis, Ralf Segersvärd, Ali A. Aghdassi, Stefano Andrianello, Peter Bossuyt, Robin Bülow, Karina Cárdenas-Jaén, P. Cortegoso, Martina Fontana, Lena Haeberle, M. Heckler, Andrey Litvin, Kulbir Mann, Christoph W. Michalski, Patrick Michl, Gennaro Nappo, Giampaolo Perri, S. Persson, F. Scheufele, Francesco Sclafani, Manuel Schmidt, L. Venezia, F. Volker, M-P Vullierm, L. Wusten 
01 May 2018-Gut
TL;DR: A conservative approach is recommended for asymptomatic MCN and IPMN, and Lifelong follow-up of IPMN is recommended in patients who are fit for surgery.
Abstract: Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring 5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

712 citations

Journal ArticleDOI
TL;DR: This guideline will provide a practical approach to pancreatic cyst management and recommendations for cyst surveillance for the general gastroenterologist.

389 citations

Journal ArticleDOI
TL;DR: A panel of molecular markers and clinical features that show promise for the accurate classification of cystic neoplasms of the pancreas and identification of cysts that require surgery are identified.

348 citations


Cites background from "Branch duct intraductal papillary m..."

  • ...Similarly, over 75% of resected IPMNs harbor only low-, or intermediate-grade dysplasia, and these also could have been safely observed.(10)...

    [...]

Journal ArticleDOI
TL;DR: Progress in genetic sequencing of pancreatic neoplasms and the identification of specific genetic mutations also holds promise for the future development of novel gene-based diagnostic tests in intraductal neoplasm of the pancreas that might even be used in preoperative conditions.

222 citations

References
More filters
Journal ArticleDOI
TL;DR: Ovarian-type stroma has been proposed as a requisite to distinguish MCN from IPMN, and some other distinct features to characterize IPMN and MCN have been identified, but there remain ambiguities between the two diseases.

1,912 citations

Journal ArticleDOI
TL;DR: Findings support both the concept of progression of benign IPMNs to invasive cancer and an aggressive policy of resection at diagnosis.
Abstract: Objective: To describe clinical characteristics and outcomes of a large cohort of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas affecting the main pancreatic duct.

737 citations

Journal ArticleDOI
TL;DR: This large cohort of resected branch-duct IPMNs shows that cancer is present in 22% of cases and validates the recent guidelines that indicate absence of malignancy in tumors <30 mm, without symptoms or mural nodules.

427 citations

Related Papers (5)