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Impact of Tumor Location on Postoperative Outcome of Intraductal Papillary Neoplasm of the Bile Duct

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Abstract

Background

The concept of intraductal papillary neoplasm of the bile duct (IPNB) has been proposed to be the biliary equivalent of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. While the classification of IPMNs is based on their location of duct involvement, such classification has not been fully evaluated for IPNBs. The aim of this study is to investigate the value of IPNB classification based on its location.

Methods

A total of 306 consecutive patients who underwent surgical resection with a diagnosis of bile duct tumor were enrolled. Among these patients, 21 were diagnosed as having IPNB. The IPNBs were classified into two groups as follows: extrahepatic IPNB, which located in the distal or perihilar bile duct, and intrahepatic IPNB, which located more peripherally than the hilar bile duct. The clinicopathological features of the two groups were then compared.

Results

Extrahepatic IPNB tended to show more invasive characteristics than intrahepatic IPNB (presence of invasive component: 40.0 vs. 9.1%, p = 0.084). Moreover, patients with extrahepatic IPNB showed significantly poorer relapse-free survival (RFS) than those with intrahepatic IPNB [5-year RFS rate (%): 81.8 vs. 16.2, p = 0.014].

Conclusion

Patients with intrahepatic IPNB show more favorable pathological characteristics and postoperative survival outcomes than those with extrahepatic IPNB.

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Abbreviations

Alb:

Albumin

ALP:

Alkaline phosphatase

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

CA19-9:

Carbohydrate antigen 19-9

CEA:

Carcinoembryonic antigen

CRP:

C-reactive protein

γ-GTP:

Gamma-glutamyltransferase

IPMN-P:

Intraductal papillary mucinous neoplasm of the pancreas

IPNB:

Intraductal papillary neoplasm of the bile duct

PLT:

Platelet

TP:

Total protein

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, 321-0293, Tochigi, Japan

    Takatsugu Matsumoto, Keiichi Kubota, Hiroyuki Hachiya, Yuhki Sakuraoka, Takayuki Shiraki, Takayuki Shimizu, Shozo Mori, Yukihiro Iso, Masato Kato & Taku Aoki

  2. Department of Diagnostic Pathology, Dokkyo Medical University Hospital, Mibu, 321-0293, Tochigi, Japan

    Hidetsugu Yamagishi & Yasuo Imai

Authors
  1. Takatsugu Matsumoto
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  2. Keiichi Kubota
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  3. Hiroyuki Hachiya
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  4. Yuhki Sakuraoka
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  5. Takayuki Shiraki
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  6. Takayuki Shimizu
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  7. Shozo Mori
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  9. Masato Kato
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  10. Hidetsugu Yamagishi
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  12. Taku Aoki
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Corresponding author

Correspondence to Takatsugu Matsumoto.

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Informed consent was obtained from all individual participants included in the study.

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Matsumoto, T., Kubota, K., Hachiya, H. et al. Impact of Tumor Location on Postoperative Outcome of Intraductal Papillary Neoplasm of the Bile Duct. World J Surg 43, 1313–1322 (2019). https://doi.org/10.1007/s00268-019-04913-3

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  • DOI: https://doi.org/10.1007/s00268-019-04913-3

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