Proposed Nomogram Predicting the Individual Risk of Malignancy in the Patients with Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas

Jin Young Jang, Taesung Park, Selyeong Lee, Yongkang Kim, Seung Yeoun Lee, Sun Whe Kim, Song Cheol Kim, Ki Byung Song, Masakazu Yamamoto, Takashi Hatori, Seiko Hirono, Sohei Satoi, Tsutomu Fujii, Satoshi Hirano, Yasushi Hashimoto, Yashuhiro Shimizu, Dong Wook Choi, Seong Ho Choi, Jin Seok Heo, Fuyuhiko MotoiIppei Matsumoto, Woo Jung Lee, Chang Moo Kang, Ho Seong Han, Yoo Seok Yoon, Masayuki Sho, Hiroaki Nagano, Goro Honda, Sang Geol Kim, Hee Chul Yu, Jun Chul Chung, Yuichi Nagakawa, Hyung Il Seo, Hiroki Yamaue

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. Background: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. Methods: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan. The patients with main duct dilatation >10 mm and inaccurate information were excluded. Results: The study cohort consisted of 2258 patients. Malignant IPMNs were defined as those with high grade dysplasia and associated invasive carcinoma. Of 2258 patients, 986 (43.7%) had low, 443 (19.6%) had intermediate, 398 (17.6%) had high grade dysplasia, and 431 (19.1%) had invasive carcinoma. To construct and validate the nomogram, patients were randomly allocated into training and validation sets, with fixed ratios of benign and malignant lesions. Multiple logistic regression analysis resulted in five variables (cyst size, duct dilatation, mural nodule, serum CA19-9, and CEA) being selected to construct the nomogram. In the validation set, this nomogram showed excellent discrimination power through a 1000 times bootstrapped calibration test. Conclusion: A nomogram predicting malignancy in patients with BD-IPMN was constructed using a logistic regression model. This nomogram may be useful in identifying patients at risk of malignancy and for selecting optimal treatment methods. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.

Original languageEnglish
Pages (from-to)1062-1068
Number of pages7
JournalAnnals of surgery
Volume266
Issue number6
DOIs
Publication statusPublished - 2017 Dec 1

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Nomograms
Pancreatic Neoplasms
Neoplasms
Logistic Models
Dilatation
Carcinoma
Korea
Tertiary Care Centers
Calibration
Cysts
Japan
Cohort Studies
Software
Regression Analysis
Databases
Guidelines

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Jang, Jin Young ; Park, Taesung ; Lee, Selyeong ; Kim, Yongkang ; Lee, Seung Yeoun ; Kim, Sun Whe ; Kim, Song Cheol ; Song, Ki Byung ; Yamamoto, Masakazu ; Hatori, Takashi ; Hirono, Seiko ; Satoi, Sohei ; Fujii, Tsutomu ; Hirano, Satoshi ; Hashimoto, Yasushi ; Shimizu, Yashuhiro ; Choi, Dong Wook ; Choi, Seong Ho ; Heo, Jin Seok ; Motoi, Fuyuhiko ; Matsumoto, Ippei ; Lee, Woo Jung ; Kang, Chang Moo ; Han, Ho Seong ; Yoon, Yoo Seok ; Sho, Masayuki ; Nagano, Hiroaki ; Honda, Goro ; Kim, Sang Geol ; Yu, Hee Chul ; Chung, Jun Chul ; Nagakawa, Yuichi ; Seo, Hyung Il ; Yamaue, Hiroki. / Proposed Nomogram Predicting the Individual Risk of Malignancy in the Patients with Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas. In: Annals of surgery. 2017 ; Vol. 266, No. 6. pp. 1062-1068.
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abstract = "Objectives: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. Background: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. Methods: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan. The patients with main duct dilatation >10 mm and inaccurate information were excluded. Results: The study cohort consisted of 2258 patients. Malignant IPMNs were defined as those with high grade dysplasia and associated invasive carcinoma. Of 2258 patients, 986 (43.7{\%}) had low, 443 (19.6{\%}) had intermediate, 398 (17.6{\%}) had high grade dysplasia, and 431 (19.1{\%}) had invasive carcinoma. To construct and validate the nomogram, patients were randomly allocated into training and validation sets, with fixed ratios of benign and malignant lesions. Multiple logistic regression analysis resulted in five variables (cyst size, duct dilatation, mural nodule, serum CA19-9, and CEA) being selected to construct the nomogram. In the validation set, this nomogram showed excellent discrimination power through a 1000 times bootstrapped calibration test. Conclusion: A nomogram predicting malignancy in patients with BD-IPMN was constructed using a logistic regression model. This nomogram may be useful in identifying patients at risk of malignancy and for selecting optimal treatment methods. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.",
author = "Jang, {Jin Young} and Taesung Park and Selyeong Lee and Yongkang Kim and Lee, {Seung Yeoun} and Kim, {Sun Whe} and Kim, {Song Cheol} and Song, {Ki Byung} and Masakazu Yamamoto and Takashi Hatori and Seiko Hirono and Sohei Satoi and Tsutomu Fujii and Satoshi Hirano and Yasushi Hashimoto and Yashuhiro Shimizu and Choi, {Dong Wook} and Choi, {Seong Ho} and Heo, {Jin Seok} and Fuyuhiko Motoi and Ippei Matsumoto and Lee, {Woo Jung} and Kang, {Chang Moo} and Han, {Ho Seong} and Yoon, {Yoo Seok} and Masayuki Sho and Hiroaki Nagano and Goro Honda and Kim, {Sang Geol} and Yu, {Hee Chul} and Chung, {Jun Chul} and Yuichi Nagakawa and Seo, {Hyung Il} and Hiroki Yamaue",
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language = "English",
volume = "266",
pages = "1062--1068",
journal = "Annals of Surgery",
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Jang, JY, Park, T, Lee, S, Kim, Y, Lee, SY, Kim, SW, Kim, SC, Song, KB, Yamamoto, M, Hatori, T, Hirono, S, Satoi, S, Fujii, T, Hirano, S, Hashimoto, Y, Shimizu, Y, Choi, DW, Choi, SH, Heo, JS, Motoi, F, Matsumoto, I, Lee, WJ, Kang, CM, Han, HS, Yoon, YS, Sho, M, Nagano, H, Honda, G, Kim, SG, Yu, HC, Chung, JC, Nagakawa, Y, Seo, HI & Yamaue, H 2017, 'Proposed Nomogram Predicting the Individual Risk of Malignancy in the Patients with Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas', Annals of surgery, vol. 266, no. 6, pp. 1062-1068. https://doi.org/10.1097/SLA.0000000000001985

Proposed Nomogram Predicting the Individual Risk of Malignancy in the Patients with Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas. / Jang, Jin Young; Park, Taesung; Lee, Selyeong; Kim, Yongkang; Lee, Seung Yeoun; Kim, Sun Whe; Kim, Song Cheol; Song, Ki Byung; Yamamoto, Masakazu; Hatori, Takashi; Hirono, Seiko; Satoi, Sohei; Fujii, Tsutomu; Hirano, Satoshi; Hashimoto, Yasushi; Shimizu, Yashuhiro; Choi, Dong Wook; Choi, Seong Ho; Heo, Jin Seok; Motoi, Fuyuhiko; Matsumoto, Ippei; Lee, Woo Jung; Kang, Chang Moo; Han, Ho Seong; Yoon, Yoo Seok; Sho, Masayuki; Nagano, Hiroaki; Honda, Goro; Kim, Sang Geol; Yu, Hee Chul; Chung, Jun Chul; Nagakawa, Yuichi; Seo, Hyung Il; Yamaue, Hiroki.

In: Annals of surgery, Vol. 266, No. 6, 01.12.2017, p. 1062-1068.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Proposed Nomogram Predicting the Individual Risk of Malignancy in the Patients with Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas

AU - Jang, Jin Young

AU - Park, Taesung

AU - Lee, Selyeong

AU - Kim, Yongkang

AU - Lee, Seung Yeoun

AU - Kim, Sun Whe

AU - Kim, Song Cheol

AU - Song, Ki Byung

AU - Yamamoto, Masakazu

AU - Hatori, Takashi

AU - Hirono, Seiko

AU - Satoi, Sohei

AU - Fujii, Tsutomu

AU - Hirano, Satoshi

AU - Hashimoto, Yasushi

AU - Shimizu, Yashuhiro

AU - Choi, Dong Wook

AU - Choi, Seong Ho

AU - Heo, Jin Seok

AU - Motoi, Fuyuhiko

AU - Matsumoto, Ippei

AU - Lee, Woo Jung

AU - Kang, Chang Moo

AU - Han, Ho Seong

AU - Yoon, Yoo Seok

AU - Sho, Masayuki

AU - Nagano, Hiroaki

AU - Honda, Goro

AU - Kim, Sang Geol

AU - Yu, Hee Chul

AU - Chung, Jun Chul

AU - Nagakawa, Yuichi

AU - Seo, Hyung Il

AU - Yamaue, Hiroki

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Objectives: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. Background: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. Methods: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan. The patients with main duct dilatation >10 mm and inaccurate information were excluded. Results: The study cohort consisted of 2258 patients. Malignant IPMNs were defined as those with high grade dysplasia and associated invasive carcinoma. Of 2258 patients, 986 (43.7%) had low, 443 (19.6%) had intermediate, 398 (17.6%) had high grade dysplasia, and 431 (19.1%) had invasive carcinoma. To construct and validate the nomogram, patients were randomly allocated into training and validation sets, with fixed ratios of benign and malignant lesions. Multiple logistic regression analysis resulted in five variables (cyst size, duct dilatation, mural nodule, serum CA19-9, and CEA) being selected to construct the nomogram. In the validation set, this nomogram showed excellent discrimination power through a 1000 times bootstrapped calibration test. Conclusion: A nomogram predicting malignancy in patients with BD-IPMN was constructed using a logistic regression model. This nomogram may be useful in identifying patients at risk of malignancy and for selecting optimal treatment methods. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.

AB - Objectives: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. Background: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. Methods: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan. The patients with main duct dilatation >10 mm and inaccurate information were excluded. Results: The study cohort consisted of 2258 patients. Malignant IPMNs were defined as those with high grade dysplasia and associated invasive carcinoma. Of 2258 patients, 986 (43.7%) had low, 443 (19.6%) had intermediate, 398 (17.6%) had high grade dysplasia, and 431 (19.1%) had invasive carcinoma. To construct and validate the nomogram, patients were randomly allocated into training and validation sets, with fixed ratios of benign and malignant lesions. Multiple logistic regression analysis resulted in five variables (cyst size, duct dilatation, mural nodule, serum CA19-9, and CEA) being selected to construct the nomogram. In the validation set, this nomogram showed excellent discrimination power through a 1000 times bootstrapped calibration test. Conclusion: A nomogram predicting malignancy in patients with BD-IPMN was constructed using a logistic regression model. This nomogram may be useful in identifying patients at risk of malignancy and for selecting optimal treatment methods. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.

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DO - 10.1097/SLA.0000000000001985

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JO - Annals of Surgery

JF - Annals of Surgery

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