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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 13/2019

15.10.2019 | Pancreatic Tumors

Accuracy of Fukuoka and American Gastroenterological Association Guidelines for Predicting Advanced Neoplasia in Pancreatic Cyst Neoplasm: A Meta-Analysis

verfasst von: Jiayuan Wu, MD, Yufeng Wang, MM, Zitao Li, MM, Huilai Miao, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 13/2019

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Abstract

Background

A differential diagnosis of advanced pancreatic cystic neoplasms (PCNs) is critical to determine optimal treatment. The Fukuoka and American Gastroenterological Association (AGA) guidelines are the most widely accepted criteria for the management of PCNs.

Objective

This study aimed to evaluate the diagnostic value of these guidelines in predicting advanced neoplasia (AN).

Methods

A comprehensive electronic search of the PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus databases was conducted to identify all relevant studies evaluating the Fukuoka and AGA guidelines in surgically resected and histologically confirmed PCNs. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated as compound measures of diagnostic accuracy using the random-effects model. Summary of receiver operating characteristic (SROC) curves and the area under the curve (AUC) were also performed.

Results

A total of 21 studies with 3723 patients were included in this meta-analysis. Of these studies, 15, 4, and 2 evaluated the Fukuoka guidelines, the AGA guidelines, and both guidelines, respectively. For AN prediction, the Fukuoka guidelines had a pooled sensitivity of 0.67 (95% confidence interval [CI] 0.64–0.70), pooled specificity of 0.64 (95% CI 0.62–0.66), and pooled DOR of 6.28 (95% CI 4.38–9.01), with an AUC of the SROC of 0.78. AGA guidelines showed a pooled sensitivity of 0.59 (95% CI 0.52–0.65), pooled specificity of 0.77 (95% CI 0.74–0.80), and pooled DOR of 5.84 (95% CI 2.60–13.15), with an AUC of 0.79 (95% CI 0.70–0.88).

Conclusion

When used alone, the Fukuoka and AGA guidelines showed similar but unsatisfactory diagnostic accuracy in the risk stratification of malignant potential of PCN. Thus, we recommend that they be applied only as a broad framework in clinical practice.
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Metadaten
Titel
Accuracy of Fukuoka and American Gastroenterological Association Guidelines for Predicting Advanced Neoplasia in Pancreatic Cyst Neoplasm: A Meta-Analysis
verfasst von
Jiayuan Wu, MD
Yufeng Wang, MM
Zitao Li, MM
Huilai Miao, MD
Publikationsdatum
15.10.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 13/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07921-8

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