Autores: Manuel-Vázquez, A. (Autor de correspondencia); Balakrishnan, A.; Agami, P.; Andersson, B.; Berrevoet, F.; Besselink, M. G.; Boggi, U.; Caputo, D.; Carabias, A.; Carrión-Álvarez, L.; Cepeda Franco, C.; Coppola, A.; Dasari, B. V. M.; Díaz-Mercedes, S.; Feretis, M.; Fondevila, C.; Fusai, G. K.; Garcea, G.; Gonzabay, V.; Gómez Bravo, M. A.; Gorris, M.; Hendrikx, B.; Hidalgo-Salinas, C.; Kadam, P.; Karavias, D.; Kauffmann, E.; Kourdouli, A.; La Vaccara, V.; van Laarhoven, S.; Leighton, J.; Liem, M. S. L.; Machairas, N.; Magouliotis, D.; Mahmoud, A.; Marino, M. V.; Massani, M.; Melgar Requena, P.; Mentor, K.; Napoli, N.; Nijhuis, J. H. T.; Nikov, A.; Nistri, C.; Nunes, V.; Ortiz Ruiz, E.; Pandanaboyana, S.; Pérez Saborido, B.; Pohnan, R.; Popa, M.; Sánchez Pérez, B.; Sánchez Bueno, F.
Resumen:
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.
