A multimodality test to guide the management of patients with a pancreatic cyst Journal Article


Authors: Springer, S.; Masica, D. L.; Dal Molin, M.; Douville, C.; Thoburn, C. J.; Afsari, B.; Li, L.; Cohen, J. D.; Thompson, E.; Allen, P. J.; Klimstra, D. S.; Schattner, M. A.; Max Schmidt, C.; Yip-Schneider, M.; Simpson, R. E.; Fernandez-Del Castillo, C.; Mino-Kenudson, M.; Brugge, W.; Brand, R. E.; Singhi, A. D.; Scarpa, A.; Lawlor, R.; Salvia, R.; Zamboni, G.; Hong, S. M.; Hwang, D. W.; Jang, J. Y.; Kwon, W.; Swan, N.; Geoghegan, J.; Falconi, M.; Crippa, S.; Doglioni, C.; Paulino, J.; Schulick, R. D.; Edil, B. H.; Park, W.; Yachida, S.; Hijioka, S.; van Hooft, J.; He, J.; Weiss, M. J.; Burkhart, R.; Makary, M.; Canto, M. I.; Goggins, M. G.; Ptak, J.; Dobbyn, L.; Schaefer, J.; Sillman, N.; Popoli, M.; Klein, A. P.; Tomasetti, C.; Karchin, R.; Papadopoulos, N.; Kinzler, K. W.; Vogelstein, B.; Wolfgang, C. L.; Hruban, R. H.; Lennon, A. M.
Article Title: A multimodality test to guide the management of patients with a pancreatic cyst
Abstract: Pancreatic cysts are common and often pose a management dilemma, because some cysts are precancerous, whereas others have little risk of developing into invasive cancers. We used supervised machine learning techniques to develop a comprehensive test, CompCyst, to guide the management of patients with pancreatic cysts. The test is based on selected clinical features, imaging characteristics, and cyst fluid genetic and biochemical markers. Using data from 436 patients with pancreatic cysts, we trained CompCyst to classify patients as those who required surgery, those who should be routinely monitored, and those who did not require further surveillance. We then tested CompCyst in an independent cohort of 426 patients, with histopathology used as the gold standard. We found that clinical management informed by the CompCyst test was more accurate than the management dictated by conventional clinical and imaging criteria alone. Application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices. Copyright © 2019 The Authors, some rights reserved.
Journal Title: Science Translational Medicine
Volume: 11
Issue: 501
ISSN: 1946-6234
Publisher: American Association for the Advancement of Science  
Date Published: 2019-07-17
Start Page: eaav4772
Language: English
DOI: 10.1126/scitranslmed.aav4772
PROVIDER: scopus
PUBMED: 31316009
DOI/URL:
Notes: Article -- Source: Scopus
Altmetric
Citation Impact
MSK Authors
  1. David S Klimstra
    913 Klimstra
  2. Peter Allen
    477 Allen
  3. Mark Schattner
    114 Schattner