Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms.

Published on Jun 1, 2014in Digestive and Liver Disease3.57
· DOI :10.1016/J.DLD.2013.12.019
Elisabetta Buscarini42
Estimated H-index: 42
,
Raffaele Pezzilli54
Estimated H-index: 54
+ 54 AuthorsAlessandro Zambelli26
Estimated H-index: 26
Sources
Abstract
This report contains clinically oriented guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms in patients fit for treatment. The statements were elaborated by working groups of experts by searching and analysing the literature, and then underwent a consensus process using a modified Delphi procedure. The statements report recommendations regarding the most appropriate use and timing of various imaging techniques and of endoscopic ultrasound, the role of circulating and intracystic markers and the pathologic evaluation for the diagnosis and follow-up of cystic pancreatic neoplasms.
📖 Papers frequently viewed together
14 Authors (Masao Tanaka, ..., Kenji Yamao)
1,578 Citations
296 Citations
465 Citations
References228
Newest
Last. Diego TorrúsH-Index: 12
view all 7 authors...
0210-5705/$-see front matter & 2009 Elsevier Espan˜a, S.L. All rights reserved.doi:10.1016/j.gastrohep.2009.07.009 Corresponding author.E-mail addresses: mpinazo@clinic.ub.es (M.J. Pinazo).Gastroenterol Hepatol. ]]]];](]):]]]–]]]Please cite this article as: Pinazo MJ, et al. Diagnosis, management and treatment of chronic Chagas’ gastrointestinal disease in areaswhere Trypanosoma cruzi infection is not endemic. Gastroenterol Hepatol. 2009. doi:10.1016/j.gastrohep.2009.07.009
26 Citations
#1Carl A. BurtisH-Index: 18
#2Edward A. AshwoodH-Index: 1
Part I: Laboratory Principles. General Laboratory Techniques and Procedures. Specimen Collection and Processing, Sources of Biological Variation. Part II: Analytical Techniques and Instrumentation. Spectrophotometric Techniques. Fluorometry, Nephelometry, And Turbidimetry. Basic Principles of Radioactivity and Its Measurement. Electrochemistry. Electrophoresis. Chromatography/Mass Spectrometry. Principlesof Immunochemical Techniques. Automation in the Clinical Laboratory. Part III: Chemometrics....
2,163 Citations
#1Marco Del Chiaro (KI: Karolinska Institutet)H-Index: 31
#2Caroline S. Verbeke (KI: Karolinska Institutet)H-Index: 39
Last. Giuseppe Zamboni (University of Verona)H-Index: 81
view all 51 authors...
Abstract Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the...
296 CitationsSource
: Since its inception in the mid-1980s of the 20th century testing for carbohydrate antigen 19-9 (CA 19-9) has raised expectation for an earlier diagnosis and accurate monitoring of several malignant diseases. After almost 30 years, the available evidences have confirmed the appropriateness and usefulness of determining CA 19-9 levels as a prognostic indicator and as a reliable tool for monitoring pancreatic and gastrointestinal cancer, but concerns have been raised about its applications in scr...
55 CitationsSource
#1Jung Hoon Kim (SNU: Seoul National University)H-Index: 23
#2Hyo Won Eun (Asan Medical Center)H-Index: 20
Last. Young Jae Kim (Soonchunhyang University Hospital)H-Index: 6
view all 5 authors...
Abstract Purpose To assess the diagnostic ability of MRI and EUS for differentiating benign from malignant pancreatic cyst focusing on cyst communication with pancreatic duct. Materials and methods During 44 months, we performed MRI on 65 pancreatic cysts. Among them, 36 patients had confirmed cyst communication with duct by ERCP or surgery and 39 patients underwent EUS. Fifty-one had proven by surgery or aspiration. Among them, 36 had confirmed malignant cysts. Two radiologists independently gr...
36 CitationsSource
#1Mohamed Othman (Mayo Clinic)H-Index: 30
#1Mohamed O. Othman (Mayo Clinic)H-Index: 27
Last. Massimo Raimondo (Mayo Clinic)H-Index: 48
view all 8 authors...
Abstract Background and aims The utility of Carcino Embryonic Antigen (CEA) in differentiating malignant from benign pancreatic cysts is controversial. We sought to examine the role of CEA in differentiating benign from malignant cysts and its utility in progression of cyst size in follow-up. Methods Retrospective chart review of patients who underwent Endoscopic Ultrasound with Fine Needle Aspiration for mucinous cysts between 1998 and 2010. CEA was measured in benign and malignant mucinous cys...
13 CitationsSource
Endoscopic ultrasonography (EUS) has gained wide acceptance as an important, minimally invasive diagnostic tool in gastroenterology, pulmonology, visceral surgery and oncology. This review focuses on data regarding risks and complications of non-interventional diagnostic EUS and EUS-guided fine-needle biopsy (EUS-FNB). Measures to improve the safety of EUS und EUS-FNB will be discussed. Due to the specific mechanical properties of echoendoscopes in EUS, there is a low but noteworthy risk of perf...
82 CitationsSource
#1Koen de Jong (UvA: University of Amsterdam)H-Index: 7
#2Jeanin E. van Hooft (UvA: University of Amsterdam)H-Index: 41
Last. Paul Fockens (UvA: University of Amsterdam)H-Index: 100
view all 7 authors...
Abstract Background. Magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are considered useful techniques in the evaluation of pancreatic cysts. Aim of this study was to prospectively compare the diagnostic value of these techniques. Methods. This study included consecutive patients who underwent MRI, EUS, and EUS-FNA for a pancreatic cyst that was eventually resected surgically. Observers scored for cyst characteristics, a distinction between mucinous and non-mucinous cysts and a s...
48 CitationsSource
#1Stefan Fritz (Heidelberg University)H-Index: 25
#2Miriam KlaussH-Index: 15
Last. Jens WernerH-Index: 73
view all 9 authors...
Objective:The aim of this study was to evaluate existing management guidelines for branch-duct intraductal papillary mucinous neoplasms (IPMNs).Background:According to current treatment guidelines (Sendai criteria), patients with asymptomatic branch-duct type IPMNs of the pancreas less than 3 cm in
180 CitationsSource
#1Deepika Nehra (Harvard University)H-Index: 17
#2Vicente Morales Oyarvide (Harvard University)H-Index: 3
Last. Carlos Fernandez-del Castillo (Harvard University)H-Index: 101
view all 10 authors...
Abstract Background/Objectives The purpose of this study is to compare surgically resected intraductal papillary mucinous neoplasms (IPMNs) in patients with and without a family history of pancreatic cancer to gain insight into differences that may suggest the need for differential management. Methods A retrospective review of patients who underwent resection of an IPMN at the Massachusetts General Hospital (1990–2011) was conducted. Three hundred and twenty-four patients of whom 45 (13.9%) had ...
27 CitationsSource
Cited By81
Newest
#1Giuseppe ZamboniH-Index: 81
#2Anna PesciH-Index: 9
Source
Source
#1Stefano CrippaH-Index: 60
Last. Marco Del Chiaro (Anschutz Medical Campus)H-Index: 31
view all 14 authors...
Abstract Background 2017 International and 2018 European guidelines are the most recent guidelines for intraductal papillary mucinous neoplasms management. Aim to evaluate the diagnostic accuracy of these guidelines in identifying malignant IPMN. Methods data from resected patients with IPMN were collected in two referral centers. Features of risk associated to cancerous degeneration described in International and European guidelines were retrospectively applied. Sensitivity, specificity, positi...
Source
#1Mi Hye Yu (Konkuk University)H-Index: 20
#2Jung Hoon Kim (Seoul National University Hospital)H-Index: 23
Last. Hyun Jeong Park (CAU: Chung-Ang University)H-Index: 13
view all 7 authors...
OBJECTIVE. The purpose of this study is to investigate the detection rate of transabdominal ultrasound (TAUS) for pancreatic cysts incidentally detected on CT or MRI as well as the factors that influence detection rates. SUBJECTS AND METHODS. Fifty-seven patients with low-risk pancreatic cysts (n = 77; cyst size, 5 mm to 3 cm) that were incidentally detected on CT or MRI were prospectively enrolled at five institutions. At each institution, TAUS was independently performed by two radiologists wh...
Source
#2Ting YangH-Index: 4
Last. Da-Li SunH-Index: 4
view all 8 authors...
This review aimed at assessing current guidelines' methodological quality systematically for pancreatic cancer's diagnosis and to reveal the heterogeneity of the recommendations among the evaluated guidelines. A systematic search was conducted to find the latest guidelines for pancreatic cancer's diagnosis. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to assess the qualified guidelines' feature. We extracted the main recommendations for the diagnosis of pancre...
Source
#1Riccardo Casadei (UNIBO: University of Bologna)H-Index: 31
#2Claudio Ricci (UNIBO: University of Bologna)H-Index: 28
Last. Francesco Minni (UNIBO: University of Bologna)H-Index: 26
view all 10 authors...
The management of IPMNs is a challenging and controversial issue because the risk of malignancy is difficult to predict. The present study aimed to assess the clinical usefulness of two preoperative nomograms for predicting malignancy of IPMNs allowing their proper management. Retrospective study of patients affected by IPMNs. Two nomograms, regarding main (MD) and branch duct (BD) IPMN, respectively, were evaluated. Only patients who underwent pancreatic resection were collected to test the nom...
Source
#1Filippo AntoniniH-Index: 9
#2Giampiero MacarriH-Index: 17
Source
#1Osman Nuri DilekH-Index: 3
#2Turan Acar (Izmir Kâtip Çelebi University)H-Index: 7
Pancreatic surgery has been one of the addresses of the most challenging interventions in surgery due to its organ location, neighborhood, and high perioperative morbidity. Pancreatic cancers are generally asymptomatic and among the deadliest cancers. Early diagnosis and management are the most critical factors in the success of the treatment. With the detection of precancerous features of cystic lesions with advanced screening methods, pancreatectomies with various extents and interventional pr...
Source
#1Mirko D'Onofrio (University of Verona)H-Index: 58
#2Giorgia Tedesco (University of Verona)H-Index: 3
Last. Claudio Bassi (University of Verona)H-Index: 110
view all 15 authors...
Abstract Purpose Magnetic Resonance (MR) is recommended to diagnose Intraductal Papillary Mucinous Neoplasms (IPMN) and in the follow-up of borderline lesions. The purpose of this work is to evaluate the diagnostic accuracy of dynamic Magnetic Resonance (MR) with Diffusion Weighted Imaging (DWI) in the identification of mural nodules of IPMN of pancreas by using pathological analysis as gold standard. Materials and methods Ninety-one preoperative MR with histopathological diagnosis of IPMN were ...
Source
Source