Journal
BRITISH JOURNAL OF SURGERY
Volume 106, Issue 13, Pages 1829-1836Publisher
OXFORD UNIV PRESS
DOI: 10.1002/bjs.11293
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Funding
- Korea Health Technology Research and Development Project through the Korea Health Industry Development Institute - Ministry of Health and Welfare, Korea [HI16C2037]
- Collaborative Genome Programme for Fostering New Post-Genome Industry of the National Research Foundation - Ministry of Science and Information and Communications Technology [NRF-2017M3C9A5031597]
- Korea Health Promotion Institute [HI16C2037010019] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Background Intraductal papillary mucinous neoplasm (IPMN) is premalignant pancreatic lesion. International guidelines offer limited predictors of individual risk. A nomogram to predict individual IPMN malignancy risk was released, with good diagnostic performance based on a large cohort of Asian patients with IPMN. The present study validated a nomogram to predict malignancy risk and invasiveness of IPMN using both Eastern and Western cohorts. Methods Clinicopathological and radiological data from patients who underwent pancreatic resection for IPMN at four centres each in Eastern and Western countries were collected. After excluding patients with missing data for at least one malignancy predictor in the nomogram (main pancreatic duct diameter, cyst size, presence of mural nodule, serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 levels, and age). Results In total, data from 393 patients who fit the criteria were analysed, of whom 265 were from Eastern and 128 from Western institutions. Although mean age, sex, log value of serum CA19-9 level, tumour location, main duct diameter, cyst size and presence of mural nodule differed between the Korean/Japanese, Eastern and Western cohorts, rates of malignancy and invasive cancer did not differ significantly. Areas under the receiver operating characteristic (ROC) curve values for the nomogram predicting malignancy were 0 center dot 745 for Eastern, 0 center dot 856 for Western and 0 center dot 776 for combined cohorts; respective values for the nomogram predicting invasiveness were 0 center dot 736, 0 center dot 891 and 0 center dot 788. Conclusions External validation of the nomogram showed good performance in predicting cancer in both Eastern and Western patients with IPMN lesions.
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