Progression of Unresected Intraductal Papillary Mucinous Neoplasms of the Pancreas to Cancer: A Systematic Review and Meta-analysis  Sang Hyun Choi, Seong Ho Park, Kyung Won Kim, Ja Youn Lee, Sang Soo Lee  Clinical Gastroenterology and Hepatology  Volume 15, Issue 10, Pages 1509-1520.e4 (October 2017) DOI: 10.1016/j.cgh.2017.03.020 Copyright © 2017 AGA Institute Terms and Conditions

Figure 1 Flow diagram of the article selection process. An article may have been excluded for multiple reasons, but only 1 major reason per article is presented. *The sum (9 + 10) is not 17 because 2 articles reported results separately for the low-risk and non–low-risk patient groups; hence, these results were considered as separate studies for the meta-analysis. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Figure 2 Meta-analytic summary of cumulative incidence of pancreatic cancer. (A) Forest plot for studies of low-risk IPMN. Study ID provides the first author's name and year of publication. Diamond marker indicates the meta-analytic summary estimate of cumulative incidence of pancreatic cancer (%). (B) Forest plot for studies of non–low-risk IPMN. (C) Meta-analytic estimates of cumulative incidence across the follow-up periods. Error bars represent 95% CI. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Figure 3 Funnel plots to evaluate publication bias. (A) Studies of low-risk IPMN. (B) Studies of non–low-risk IPMN. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 1 Summary of quality of the included articles. Quality of the articles is presented as the proportion of articles (0%−100%) for each variable. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 2 Meta-analytic results of a subgroup of studies of low-risk IPMN, which fulfilled the clearer definition for low risk. (A) Forest plot. Study ID provides first author's name and year of publication. Diamond marker indicates meta-analytic summary estimate of cumulative incidence (%) of pancreatic cancer. (B) Meta-analytic estimates of cumulative incidence across follow-up time points are displayed graphically. Error bars represent 95% CI. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 2 Meta-analytic results of a subgroup of studies of low-risk IPMN, which fulfilled the clearer definition for low risk. (A) Forest plot. Study ID provides first author's name and year of publication. Diamond marker indicates meta-analytic summary estimate of cumulative incidence (%) of pancreatic cancer. (B) Meta-analytic estimates of cumulative incidence across follow-up time points are displayed graphically. Error bars represent 95% CI. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 3 Meta-analytic results of high-quality subgroup of the studies of low-risk IPMN. (A) Forest plot. Study ID provides first author's name and year of publication. Diamond marker indicates meta-analytic summary estimate of cumulative incidence (%) of pancreatic cancer. (B) Meta-analytic estimates of cumulative incidence across the follow-up time points are displayed graphically. Error bars represent 95% CI. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 3 Meta-analytic results of high-quality subgroup of the studies of low-risk IPMN. (A) Forest plot. Study ID provides first author's name and year of publication. Diamond marker indicates meta-analytic summary estimate of cumulative incidence (%) of pancreatic cancer. (B) Meta-analytic estimates of cumulative incidence across the follow-up time points are displayed graphically. Error bars represent 95% CI. Clinical Gastroenterology and Hepatology 2017 15, 1509-1520.e4DOI: (10.1016/j.cgh.2017.03.020) Copyright © 2017 AGA Institute Terms and Conditions