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


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Springer, S; Masica, DL; Dal Molin, M; Douville, C; Thoburn, CJ; Afsari, B; Li, L; Cohen, JD; Thompson, E; Allen, PJ; Klimstra, DS; Schattner, MA; Schmidt, CM; Yip-Schneider, M; Simpson, RE; Fernandez-Del Castillo, C; Mino-Kenudson, M; Brugge, W; Brand, RE; Singhi, AD; Scarpa, A; Lawlor, R; Salvia, R; Zamboni, G; Hong, S-M; Hwang, DW; Jang, J-Y; Kwon, W; Swan, N; Geoghegan, J; Falconi, M; Crippa, S; Doglioni, C; Paulino, J; Schulick, RD; Edil, BH; Park, W; Yachida, S; Hijioka, S; van Hooft, J; He, J; Weiss, MJ; Burkhart, R; Makary, M; Canto, MI; Goggins, MG; Ptak, J; Dobbyn, L; Schaefer, J; Sillman, N; Popoli, M; Klein, AP; Tomasetti, C; Karchin, R; Papadopoulos, N; Kinzler, KW; Vogelstein, B; Wolfgang, CL; Hruban, RH; Lennon, AM

Published Date

  • July 17, 2019

Published In

Volume / Issue

  • 11 / 501

PubMed ID

  • 31316009

Pubmed Central ID

  • 31316009

Electronic International Standard Serial Number (EISSN)

  • 1946-6242

Digital Object Identifier (DOI)

  • 10.1126/scitranslmed.aav4772


  • eng

Conference Location

  • United States