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Journal of Gastrointestinal Surgery

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01-05-2013 | Original Article

Impact of Macroscopic Morphology, Multifocality, and Mucin Secretion on Survival Outcome of Intraductal Papillary Neoplasm of the Bile Duct

Authors: Mee Joo Kang, Jin-Young Jang, Kyoung Bun Lee, In Woong Han, Sun-Whe Kim

Published in: Journal of Gastrointestinal Surgery | Issue 5/2013

Abstract

Background

Intraductal papillary neoplasms of the bile duct (IPNB) are relatively rare disease with favorable prognosis. The authors investigated clinicopathologic characteristics and prognostic factors of IPNB in viewpoint of macroscopic morphology and multiplicity.

Methods

Data were collected from 84 patients who underwent surgery at Seoul National University Hospital with diagnosis of IPNB from 2000 to 2009.

Results

Median follow-up was 41.8 months and 75 (89.3 %) had invasive cancer. Tumors were confined to the bile duct in 45 patients (53.6 %) and 8 (9.5 %) had lymph node metastasis. Curative resection was achieved in 70 patients (89.3 %). Mucin secretion was identified in 23 (28.0 %) and 43 (51.2 %) had multiple tumors. Multiple IPNB had poor prognosis compared with single IPNB (5-year survival rate 50.7 vs. 85.9 %; P = 0.011). Positive resection margin (P = 0.046) and multiplicity (P = 0.038) were independent prognostic factors of IPNB after multivariate analysis. Mucin secretion had no impact on survival outcome (P = 0.595). The disease-free survival rate was significantly lower in multiple IPNB compared with single IPNB (5-year disease free survival rates 36.1 vs. 74.1 %; P = 0.026).

Conclusion

Multiplicity is a common feature of IPNB and has a negative impact on prognosis. Current WHO classification for IPNB needs consideration for macroscopic morphology and multiplicity considering its prognostic impact of IPNB.

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Title: Impact of Macroscopic Morphology, Multifocality, and Mucin Secretion on Survival Outcome of Intraductal Papillary Neoplasm of the Bile Duct
Authors: Mee Joo Kang
Jin-Young Jang
Kyoung Bun Lee
In Woong Han
Sun-Whe Kim
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 5/2013
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2151-3

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Impact of Macroscopic Morphology, Multifocality, and Mucin Secretion on Survival Outcome of Intraductal Papillary Neoplasm of the Bile Duct

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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