Vor Luvira1, Ake Pugkhem1, Vajarabhongsa Bhudhisawasdi1, Chawalit Pairojkul2, Egapong Sathitkarnmanee1, Varisara Luvira3, Supot Kamsa-Ard4. 1. Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. 2. Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. 3. Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. 4. Cancer Unit, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
Abstract
BACKGROUND AND AIMS: Intraductal papillary neoplasm of the bile duct (IPNB) is a specific type of bile duct tumor. Studies about the surgical outcomes for IPNB are few; therefore, we investigated the survival of patients who underwent curative surgical resection of IPNB. METHODS: We retrospectively reviewed the medical and pathological records of 148 IPNB patients who underwent curative-intent hepatic resection between January 2005 and December 2011, to examine the prognosis of IPNB. All demographic and operative parameters were analyzed the effect on survival of patients. RESULTS: The median survival of IPNB patients was 1326 days with a respective 1, 3, and 5 year overall survival of 83.6% (95%CI: 76.5-88.7), 64.4% (95%CI: 56.0-71.6), and 47% (95%CI: 38.4-55.7). The level of invasiveness of IPNB predicted survival very well. For malignant IPNB, univariate analysis showed that serum CA19-9 level, lymph node metastasis, and completeness of resection were significant prognostic factors. Lymph node metastasis and completeness of resection were found in multivariate analysis to be significantly related to survival of the patients. CONCLUSIONS: The level of invasiveness and lymph node status were found to be associated with patient survival, as was adequacy of surgery. We recommend R0 resection be attempted for patients with IPNB.
BACKGROUND AND AIMS: Intraductal papillary neoplasm of the bile duct (IPNB) is a specific type of bile duct tumor. Studies about the surgical outcomes for IPNB are few; therefore, we investigated the survival of patients who underwent curative surgical resection of IPNB. METHODS: We retrospectively reviewed the medical and pathological records of 148 IPNBpatients who underwent curative-intent hepatic resection between January 2005 and December 2011, to examine the prognosis of IPNB. All demographic and operative parameters were analyzed the effect on survival of patients. RESULTS: The median survival of IPNBpatients was 1326 days with a respective 1, 3, and 5 year overall survival of 83.6% (95%CI: 76.5-88.7), 64.4% (95%CI: 56.0-71.6), and 47% (95%CI: 38.4-55.7). The level of invasiveness of IPNB predicted survival very well. For malignant IPNB, univariate analysis showed that serum CA19-9 level, lymph node metastasis, and completeness of resection were significant prognostic factors. Lymph node metastasis and completeness of resection were found in multivariate analysis to be significantly related to survival of the patients. CONCLUSIONS: The level of invasiveness and lymph node status were found to be associated with patient survival, as was adequacy of surgery. We recommend R0 resection be attempted for patients with IPNB.
Authors: Matthew H Lee; Venkata S Katabathina; Meghan G Lubner; Hardik U Shah; Srinivasa R Prasad; Kristina A Matkowskyj; Perry J Pickhardt Journal: Radiographics Date: 2021-10 Impact factor: 6.312