Dynamics of Fukuoka Criteria and Patient Management in Pancreatic Intraductal Papillary Mucinous Neoplasms (IPMNs) During Follow-Up
Schellhaas B, Vitali F, Wildner D, Görtz R, Pfeifer L, Konturek PC, Neurath M, Strobel D (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 23
Pages Range: 1483-1492
Abstract
BACKGROUND Pancreatic intraductal papillary mucinous neoplasms (IPMNs) present a clinical challenge. Evidence-based guidelines are lacking. The so-called "Fukuoka criteria" were developed to assess the risk of malignancy in IPMNs upon imaging. However, little is known about their diagnostic value and the natural course of IPMNs. Thus, the aim of this study was the assessment of Fukuoka criteria and patient management in pancreatic IPMNs -during follow-up. MATERIAL AND METHODS IPMNs were identified via retrospective survey of endoscopic ultrasound (EUS) examinations. Fukuoka criteria were assessed on EUS findings and additional imaging (CT, MRI, ultrasound). Patients' symptoms and comorbidities were recorded. Dynamics of Fukuoka criteria and patient management were compared at first presentation and during follow-up. RESULTS We screened 1324 EUS examinations. Sixty-five patients (male/female, 14/37; mean age, 68.8 years; range, 48-85 years) with IPMNs were identified (57 branch duct (BD-)IPMNs, 3 main duct (MD-) IPMNs, 5 mixed-type (MT)-IPMNs). Seven patients received surgical resection (4 BD-IPMNs, 2 MD-IPMNs, 1 MT-IPMN). Nine BD-IPMNs had neither surgery nor follow-up. Fifty-one patients (44 BD-IPMNs, 2 MD-IPMNs, 5 MT-IPMNs) underwent follow-up (mean duration, 18.7 months; range, 3-139 months). There were 15/51 patients who were initially Fukuoka-positive. One MD-IPMN, 4/5 MT-IPMNs, and 13/44 BD-IPMNs showed progressive changes but were not resected due to patients' refusal or comorbidities. Four BD-IPMNs converted to Fukuoka-positive. CONCLUSIONS Evidence-based guidelines for non-invasive dignity assessment of IPMNs are lacking. In our study, MD-IPMNs displayed greater dynamics than BD-IPMNs and MT-IPMNs concerning Fukuoka criteria. Prospective long-term studies are needed to clarify prognostic significance of the single Fukuoka criteria and sensible duration of follow-up.
Authors with CRIS profile
Francesco Vitali
Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology
Dane Wildner
Medizinische Fakultät
Rüdiger Görtz
Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology
Lukas Pfeifer
Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology
Markus Neurath
Lehrstuhl für Innere Medizin I (Medizin 1)
Deike Strobel
Medizinische Fakultät
Involved external institutions
Germany (DE)How to cite
APA:
Schellhaas, B., Vitali, F., Wildner, D., Görtz, R., Pfeifer, L., Konturek, P.C.,... Strobel, D. (2017). Dynamics of Fukuoka Criteria and Patient Management in Pancreatic Intraductal Papillary Mucinous Neoplasms (IPMNs) During Follow-Up. Medical Science Monitor, 23, 1483-1492.
MLA:
Schellhaas, Barbara, et al. "Dynamics of Fukuoka Criteria and Patient Management in Pancreatic Intraductal Papillary Mucinous Neoplasms (IPMNs) During Follow-Up." Medical Science Monitor 23 (2017): 1483-1492.
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