Journal of Gastrointestinal Surgery

, Volume 17, Issue 5, pp 931–938

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

  • Mee Joo Kang
  • Jin-Young Jang
  • Kyoung Bun Lee
  • In Woong Han
  • Sun-Whe Kim
Original Article

DOI: 10.1007/s11605-013-2151-3

Cite this article as:
Kang, M.J., Jang, JY., Lee, K.B. et al. J Gastrointest Surg (2013) 17: 931. doi:10.1007/s11605-013-2151-3

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.

Keywords

CarcinomaPapillaryBile duct neoplasmsCholangiocarcinomaMucinsPapillomatosis

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Mee Joo Kang
    • 1
  • Jin-Young Jang
    • 1
    • 3
  • Kyoung Bun Lee
    • 2
  • In Woong Han
    • 1
  • Sun-Whe Kim
    • 1
  1. 1.Department of Surgery and Cancer Research InstituteSeoul National University College of MedicineSeoulSouth Korea
  2. 2.Department of PathologySeoul National University College of MedicineSeoulSouth Korea
  3. 3.Department of SurgerySeoul National University College of MedicineSeoulSouth Korea