(ChemotherapyAdvisor) – Multivariate nomogram models representing demographic, perioperative, and radiologic imaging characteristics predict patients’ risks of progression of adenomas to high-grade dysplasia/carcinoma in situ (HGD-CIS) and invasive carcinoma in main and branch-duct intraductal papillary mucinous neoplasms of the pancreas (IPMN), according to a study presented at the 66th Annual Society of Surgical Oncology (SSO) Cancer Symposium in National Harbor, MD.
“This study developed two nomograms that can be used to predict a patient’s individual likelihood of harboring high-grade dysplasia or invasive malignancy in radiologically diagnosed IPMN,” reported C. Correa and coauthors from the Memorial Sloan-Kettering Cancer Center in New York, NY. “External validation is ongoing.”
Preoperative detection of patients with a high risk of IPMN carcinomas “remains a challenging task,” the coauthors reported. “Even with strict criteria, the majority of resected lesions lack high grade dysplasia or invasive carcinoma on final pathologic examination.”
In order to develop and validate prognostic nomograms, the researchers evaluated data for patients who had undergone surgical resection for histologically confirmed IPMN and for whom preoperative images were available for review.
“Three blinded hepatobiliary radiologists independently reviewed preoperative imaging and recorded cyst characteristics including diameter, presence of solid component, and subtype; mixed-type IPMNs were grouped with main-duct lesions,” they reported.
Two independent nomograms were then devised to predict progression from adenoma to HGD-CIS or invasive carcinoma.
“Two-hundred and nineteen patients who met criteria for this study were identified,” the coauthors reported. “Branch duct IPMN (bdIPMN) comprised 56% of the resected lesions. The proportion of HGD-CIS was 15% for bdIPMN and 33% for mdIPMN (P=0.003). Invasive carcinoma was identified in 15% of bdIPMN and 41% of main-duct lesions (P<0.001).”
Patient gender, previous malignancies, presence of solid component, and weight loss were each significantly associated with patient outcomes (for mdIPMN) and were therefore included the nomograms.
The abstract (#7) for this presentation is available at the 66th Annual SSO Cancer Symposium’s website.