Abstract
Purpose
A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort.
Methods
An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included.
Results
A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07–1.77), with a sensitivity of 57.1% and specificity of 64.4%.
Conclusion
Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.
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Study conception and design: Alba Manuel-Vázquez, José Manuel Ramia. Acquisition of data: all the authors. Analysis and interpretation of data: Alba Manuel-Vázquez A, Anita Balakrishnan, José Manuel Ramia. Drafting of manuscript: Alba Manuel-Vázquez A, Anita Balakrishnan, Mickaël Lesurtel, José Manuel Ramia. Critical revision of manuscript: all the authors.
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Manuel-Vázquez, A., Balakrishnan, A., Agami, P. et al. A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation. Langenbecks Arch Surg 407, 3447–3455 (2022). https://doi.org/10.1007/s00423-022-02687-2
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DOI: https://doi.org/10.1007/s00423-022-02687-2