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Prognostic Factors for Surgically Resected Intraductal Papillary Neoplasm of the Bile Duct: A Retrospective Cohort Study

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

To date, postoperative prognostic factors for intraductal papillary neoplasm of the bile duct (IPNB) have not been well-established. This study aimed to examine the histopathologic features and postoperative prognosis of the two IPNB subclassifications, as well as factors affecting prognosis, based on the authors’ experience at a single institution.

Methods

The study enrolled 83 patients who underwent surgical resection for pathologically diagnosed IPNB at the authors’ institution. The clinicopathologic features and postoperative outcomes for these patients were examined. The study also investigated postoperative prognostic factors for IPNB using uni- and multivariate analyses.

Results

More than half of the tumors (64%) diagnosed as IPNB were early-stage cancer (UICC Tis or T1). However, none were diagnosed as benign. The multivariate analysis showed that lymph node metastasis (hazard ratio [HR], 5.78; p = 0.002) and bile duct margin status with carcinoma in situ (D-CIS; HR, 5.10; p = 0.002) were independent prognostic factors, whereas MUC6 expression showed only a marginal influence on prediction of prognosis (HR, 0.32; p = 0.07). The tumor recurrence rate and the proportion of locoregional recurrence were significantly greater among the patients with D-CIS than among those with negative bile duct margins, including those patients with low-grade dysplasia. The patients with D-CIS showed a significantly poorer prognosis than those with negative bile duct margins (5-year survival, 38% versus 87%; p = 0.0002).

Conclusions

Evaluation of resected IPNBs showed cancer in all cases. Avoiding positive biliary stumps during surgery, including resection of carcinoma in situ, would improve the prognosis for patients with IPNB.

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Acknowledgments

The authors thank Editage (www.editage.jp) for English language editing. This work was funded by the JSPS KAKENHI, Grant No. 18K08632. The funding organization had no role in the study design; in the collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan

    Shuichiro Uemura MD, PhD, Ryota Higuchi MD, PhD, Takehisa Yazawa MD, PhD, Wataru Izumo MD, PhD, Yutaro Matsunaga MD, Masahiro Shiihara MD, Takehiro Ota MD, PhD & Masakazu Yamamoto MD, PhD

  2. Department of Investigative Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

    Toru Furukawa MD, PhD

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  1. Shuichiro Uemura MD, PhD
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  2. Ryota Higuchi MD, PhD
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  4. Wataru Izumo MD, PhD
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  9. Masakazu Yamamoto MD, PhD
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Correspondence to Ryota Higuchi MD, PhD.

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Uemura, S., Higuchi, R., Yazawa, T. et al. Prognostic Factors for Surgically Resected Intraductal Papillary Neoplasm of the Bile Duct: A Retrospective Cohort Study. Ann Surg Oncol 28, 826–834 (2021). https://doi.org/10.1245/s10434-020-08835-6

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  • DOI: https://doi.org/10.1245/s10434-020-08835-6

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