@article{bf13ac12cb8842a6ba7eef90a9f76a68,
title = "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",
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.",
keywords = "cancer, intraductal papillary mucinous neoplasms of the pancreas, malignancy prediction, nomogram, radiology",
author = "Kim, {Hyeong Seok} and Wookyeong Song and Wonho Choo and Sungyoung Lee and Youngmin Han and Claudio Bassi and Roberto Salvia and Giovanni Marchegiani and Wolfgang, {Christopher L.} and Jin He and Blair, {Alex B.} and Kluger, {Michael D.} and Su, {Gloria H.} and Kim, {Song Cheol} and Ki-Byung Song and Masakazu Yamamoto and Takashi Hatori and Ching-Yao Yang and Hiroki Yamaue and Seiko Hirono and Sohei Satoi and Tsutomu Fujii and Satoshi Hirano and Wenhui Lou and Yasushi Hashimoto and Yasuhiro Shimizu and {del Chiaro}, Marco and Roberto Valente and Matthias Lohr 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 Yi-Ming Shyr and Shin-E. Wang and Ho-Seong Han and Yoo-Seok Yoon and Besselink, {Marc G.} and {van Huijgevoort}, {Nadine C. M.} and Masayuki Sho and Hiroaki Nagano and Kim, {Sang Geol} and Goro Honda and Yinmo Yang and Yu, {Hee Chul} and Yang, {Jae Do} and Chung, {Jun Chul} and Yuichi Nagakawa and Seo, {Hyung Il} and Seungyeoun Lee and Hongbeom Kim and Wooil Kwon and Taesung Park and Jin-Young Jang",
note = "Funding Information: This study was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI16C2037). Publisher Copyright: {\textcopyright} 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery",
year = "2021",
doi = "https://doi.org/10.1002/jhbp.962",
language = "English",
journal = "Journal of Hepato-Biliary-Pancreatic Sciences",
issn = "1868-6974",
publisher = "Wiley-Blackwell",
}