Evaluation of the Sendai and 2012 International Consensus Guidelines based on cross-sectional imaging findings performed for the initial triage of mucinous cystic lesions of the pancreas: a single institution experience with 114 surgically treated patients.
BACKGROUND
The Sendai Consensus Guidelines (SCG) were formulated in 2006 to guide the management of mucinous cystic lesions of the pancreas (CLPs) and were updated in 2012 (International Consensus Guidelines, ICG 2012). This study aims to evaluate the clinical utility of the ICG 2012 with the SCG based on initial cross-sectional imaging findings.


METHODS
One hundred fourteen patients with mucinous CLPs were reviewed and classified according to the ICG 2012 as high risk (HR(ICG2012)), worrisome (W(ICG2012)), and low risk (LR(ICG2012)), and according to the SCG as high risk (HR(SCG)) and low risk (LR(SCG)).


RESULTS
On univariate analysis, the presence of symptoms, obstructive jaundice, elevated serum carcinoembryonic antigen (CEA)/carbohydrate antigen (CA)19-9, solid component, main pancreatic duct ≥ 10 mm, and main pancreatic duct ≥ 5 mm was associated with high grade dysplasia/invasive carcinoma in all mucinous CLPs. Increasing number of HR(SCG) or HR(ICG2012) features was associated with a significantly increased likelihood of malignancy. The positive predictive value of HR(SCG) and HR(ICG2012) for high grade dysplasia/invasive carcinoma was 46% and 62.5% respectively. The negative predictive value of both LR(SCG) and LR(ICG2012) was 100%.


CONCLUSION
Both the guidelines were useful in the initial cross-sectional imaging evaluation of mucinous CLPs. The ICG 2012 guidelines were superior to the SCG guidelines.
['Goh|Brian K P|BK|', 'Thng|Choon-Hua|CH|', 'Tan|Damien M Y|DM|', 'Low|Albert S C|AS|', 'Wong|Jen-San|JS|', 'Cheow|Peng-Chung|PC|', 'Chow|Pierce K H|PK|', 'Chung|Alexander Y F|AY|', 'Wong|Wai-Keong|WK|', 'Ooi|London L P J|LL|']
D002288:Adenocarcinoma, Mucinous D000328:Adult D000368:Aged D014408:Biomarkers, Tumor D021441:Carcinoma, Pancreatic Ductal D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010190:Pancreatic Neoplasms D017410:Practice Guidelines as Topic D011237:Predictive Value of Tests D011859:Radiography D012189:Retrospective Studies
Guidelines Cystic lesion of the pancreas Intraductal papillary mucinous neoplasm Pancreatic cyst Pancreatic cystic neoplasm