Natsuko Kawada, Hiroyuki Uehara, Shigenori Nagata, Mutsumi Tsuchishima, Mikihiro Tsutsumi, Yasuhiko Tomita
Objective Indication of surgery for branch duct intraductal papillary mucinous neoplasm (BD-IPMN) proposed by the consensus guidelines revised in 2012 was too complex to refer to in clinical practice. This study aimed to identify simple predictors of malignancy in BD-IPMN. Methods Consecutive 202 patients with BD-IPMNs were enrolled. They comprised 35 patients that underwent surgery and 167 that were followed up without surgery by being regarded as benign neoplasms. Cutoff values of cyst size, main pancreatic duct (MPD) diameter, and mural nodule size were determined by receiver operator characteristic (ROC) curve. Factors that may discriminate benign from malignant BD-IPMNs were analyzed by multivariate logistic regression model. Results Cutoff values of cyst size, MPD diameter, and mural nodule size were determined to be 30mm, 6mm, and 10mm, respectively. Multivariate analysis demonstrated that mural nodule ≥10mm (OR 198, 95%CI 23.1-1690, p
