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Development, validation, and comparison of a nomogram based on radiologic findings for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: An international multicenter study

Authors
 Hyeong Seok Kim  ;  Wookyeong Song  ;  Wonho Choo  ;  Sungyoung Lee  ;  Youngmin Han  ;  Claudio Bassi  ;  Roberto Salvia  ;  Giovanni Marchegiani  ;  Christopher L Wolfgang  ;  Jin He  ;  Alex B Blair  ;  Michael D Kluger  ;  Gloria H Su  ;  Song Cheol Kim  ;  Ki-Byung Song  ;  Masakazu Yamamoto  ;  Takashi Hatori  ;  Ching-Yao Yang  ;  Hiroki Yamaue  ;  Seiko Hirono  ;  Sohei Satoi  ;  Tsutomu Fujii  ;  Satoshi Hirano  ;  Wenhui Lou  ;  Yasushi Hashimoto  ;  Yasuhiro Shimizu  ;  Marco Del Chiaro  ;  Roberto Valente  ;  Matthias Lohr  ;  Dong Wook Choi  ;  Seong Ho Choi  ;  Jin Seok Heo  ;  Fuyuhiko Motoi  ;  Ippei Matsumoto  ;  Woo Jung Lee  ;  Chang Moo Kang  ;  Yi-Ming Shyr  ;  Shin-E Wang  ;  Ho-Seong Han  ;  Yoo-Seok Yoon  ;  Marc G Besselink  ;  Nadine C M van Huijgevoort  ;  Masayuki Sho  ;  Hiroaki Nagano  ;  Sang Geol Kim  ;  Goro Honda  ;  Yinmo Yang  ;  Hee Chul Yu  ;  Jae Do Yang  ;  Jun Chul Chung  ;  Yuichi Nagakawa  ;  Hyung Il Seo  ;  Seungyeoun Lee  ;  Hongbeom Kim  ;  Wooil Kwon  ;  Taesung Park  ;  Jin-Young Jang 
Citation
 JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, Vol.30(1) : 133-143, 2023-01 
Journal Title
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
ISSN
 1868-6974 
Issue Date
2023-01
MeSH
Adenocarcinoma, Mucinous* / diagnostic imaging ; Adenocarcinoma, Mucinous* / pathology ; Adenocarcinoma, Mucinous* / surgery ; Biomarkers, Tumor ; Carcinoma, Pancreatic Ductal* / diagnostic imaging ; Carcinoma, Pancreatic Ductal* / pathology ; Carcinoma, Pancreatic Ductal* / surgery ; Carcinoma, Papillary* / pathology ; Humans ; Hyperplasia ; Nomograms ; Pancreatic Intraductal Neoplasms* / diagnostic imaging ; Pancreatic Neoplasms* / diagnostic imaging ; Pancreatic Neoplasms* / pathology ; Pancreatic Neoplasms* / surgery ; Retrospective Studies
Keywords
cancer ; intraductal papillary mucinous neoplasms of the pancreas ; malignancy prediction ; nomogram ; radiology
Abstract
Background Although we previously proposed a nomogram to predict malignancy in intraductal papillary mucinous neoplasms (IPMN) and validated it in an external cohort, its application is challenging without data on tumor markers. Moreover, existing nomograms have not been compared. This study aimed to develop a nomogram based on radiologic findings and to compare its performance with previously proposed American and Korean/Japanese nomograms. Methods We recruited 3708 patients who underwent surgical resection at 31 tertiary institutions in eight countries, and patients with main pancreatic duct >10 mm were excluded. To construct the nomogram, 2606 patients were randomly allocated 1:1 into training and internal validation sets, and area under the receiver operating characteristics curve (AUC) was calculated using 10-fold cross validation by exhaustive search. This nomogram was then validated and compared to the American and Korean/Japanese nomograms using 1102 patients. Results Among the 2606 patients, 90 had main-duct type, 900 had branch-duct type, and 1616 had mixed-type IPMN. Pathologic results revealed 1628 low-grade dysplasia, 476 high-grade dysplasia, and 502 invasive carcinoma. Location, cyst size, duct dilatation, and mural nodule were selected to construct the nomogram. AUC of this nomogram was higher than the American nomogram (0.691 vs 0.664, P = .014) and comparable with the Korean/Japanese nomogram (0.659 vs 0.653, P = .255). Conclusions A novel nomogram based on radiologic findings of IPMN is competitive for predicting risk of malignancy. This nomogram would be clinically helpful in circumstances where tumor markers are not available. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.962
DOI
10.1002/jhbp.962
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/199688
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