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The 2012 International Consensus Guidelines of Intraductal Papillary Mucinous Neoplasms of the Pancreas (Fukuoka Criteria) Predict the Malignant Potential, Even in Actual Clinical Situations

Okamura, Yukiyasu, MD, PhD, FACS*; Sano, Shusei, MD*; Sugiura, Teiichi, MD, PhD*; Ito, Takaaki, MD, PhD*; Yamamoto, Yusuke, MD*; Ashida, Ryo, MD*; Ishiwatari, Hirotoshi, MD, PhD; Matsubayashi, Hiroyuki, MD, PhD; Sasaki, Keiko, MD, PhD; Uesaka, Katsuhiko, MD, PhD*

doi: 10.1097/MPA.0000000000001001
Original Articles

Objectives The aim of the present study was to validate the use of the 2012 International Consensus Guidelines for intraductal papillary mucinous neoplasm (IPMN) (Fukuoka criteria) in patients without findings of obstructive jaundice and/or an enhanced solid component.

Methods This retrospective study included patients who underwent pancreatectomy for IPMN between October 2002 and September 2016. The sensitivity, specificity, and positive and negative predictive values for malignancy were calculated for each feature of high-risk stigmata.

Results Of the 135 patients who underwent surgery for IPMN, 50 (37.0%) had low/intermediate-grade dysplasia, 25 (18.5%) had high-grade dysplasia, and the remaining 60 (44.5%) had invasive carcinoma. A malignant potential was, thus, present in 63% of all resected cases. Considering an actual clinical situation, the predictors for malignant potential were assessed in 62 patients without findings of obstructive jaundice and/or an enhanced solid component. A multivariate analysis revealed that the Fukuoka criteria were the only independent factor for predicting the malignant potential (odds ratio, 5.69; P = 0.036).

Conclusions The present study suggested that malignant potential can be accurately detected by faithfully keeping to the Fukuoka criteria. Using these criteria enables us to identify patients with malignant potential, even in the actual clinical situations.

From the Divisions of *Hepato-Biliary-Pancreatic Surgery, †Endoscopy and ‡Diagnostic Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.

Received for publication March 6, 2017; accepted December 13, 2017.

Address correspondence to: Yukiyasu Okamura, MD, PhD, FACS, Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka 411-8777, Japan (e-mail:

The authors declare no conflict of interest.

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