Intraductal papillary neoplasms of the bile duct: a European retrospective multicenter observational study (EUR-IPNB study).
Journal
International journal of surgery (London, England)
ISSN: 1743-9159
Titre abrégé: Int J Surg
Pays: United States
ID NLM: 101228232
Informations de publication
Date de publication:
01 Apr 2023
01 Apr 2023
Historique:
received:
31
08
2022
accepted:
19
01
2023
medline:
27
4
2023
pubmed:
15
3
2023
entrez:
14
3
2023
Statut:
epublish
Résumé
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare disease in Western countries. The main aim of this study was to characterize current surgical strategies and outcomes in the mainly European participating centers. A multi-institutional retrospective series of patients with a diagnosis of IPNB undergoing surgery between 1 January 2010 and 31 December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association. The textbook outcome (TO) was defined as a non-prolonged length of hospital stay plus the absence of any Clavien-Dindo grade at least III complications, readmission, or mortality within 90 postoperative days. A total of 28 centers contributed 85 patients who underwent surgery for IPNB. The median age was 66 years (55-72), 49.4% were women, and 87.1% were Caucasian. Open surgery was performed in 72 patients (84.7%) and laparoscopic in 13 (15.3%). TO was achieved in 54.1% of patients, reaching 63.8% after liver resection and 32.0% after pancreas resection. Median overall survival was 5.72 years, with 5-year overall survival of 63% (95% CI: 50-82). Overall survival was better in patients with Charlson comorbidity score 4 or less versus more than 4 ( P =0.016), intrahepatic versus extrahepatic tumor ( P =0.027), single versus multiple tumors ( P =0.007), those who underwent hepatic versus pancreatic resection ( P =0.017), or achieved versus failed TO ( P =0.029). Multivariable Cox regression analysis showed that not achieving TO (HR: 4.20; 95% CI: 1.11-15.94; P =0.03) was an independent prognostic factor of poor overall survival. Patients undergoing liver resection for IPNB were more likely to achieve a TO outcome than those requiring a pancreatic resection. Comorbidity, tumor location, and tumor multiplicity influenced overall survival. TO was an independent prognostic factor of overall survival.
Sections du résumé
BACKGROUND/PURPOSE
OBJECTIVE
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare disease in Western countries. The main aim of this study was to characterize current surgical strategies and outcomes in the mainly European participating centers.
METHODS
METHODS
A multi-institutional retrospective series of patients with a diagnosis of IPNB undergoing surgery between 1 January 2010 and 31 December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association. The textbook outcome (TO) was defined as a non-prolonged length of hospital stay plus the absence of any Clavien-Dindo grade at least III complications, readmission, or mortality within 90 postoperative days.
RESULTS
RESULTS
A total of 28 centers contributed 85 patients who underwent surgery for IPNB. The median age was 66 years (55-72), 49.4% were women, and 87.1% were Caucasian. Open surgery was performed in 72 patients (84.7%) and laparoscopic in 13 (15.3%). TO was achieved in 54.1% of patients, reaching 63.8% after liver resection and 32.0% after pancreas resection. Median overall survival was 5.72 years, with 5-year overall survival of 63% (95% CI: 50-82). Overall survival was better in patients with Charlson comorbidity score 4 or less versus more than 4 ( P =0.016), intrahepatic versus extrahepatic tumor ( P =0.027), single versus multiple tumors ( P =0.007), those who underwent hepatic versus pancreatic resection ( P =0.017), or achieved versus failed TO ( P =0.029). Multivariable Cox regression analysis showed that not achieving TO (HR: 4.20; 95% CI: 1.11-15.94; P =0.03) was an independent prognostic factor of poor overall survival.
CONCLUSIONS
CONCLUSIONS
Patients undergoing liver resection for IPNB were more likely to achieve a TO outcome than those requiring a pancreatic resection. Comorbidity, tumor location, and tumor multiplicity influenced overall survival. TO was an independent prognostic factor of overall survival.
Identifiants
pubmed: 36917142
doi: 10.1097/JS9.0000000000000280
pii: 01279778-202304000-00013
pmc: PMC10389541
doi:
Types de publication
Observational Study
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
760-771Informations de copyright
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Références
Ainechi S, Lee H. Updates on precancerous lesions of the biliary tract: biliary precancerous lesion. Arch Pathol Lab Med 2016;140:1285–1289.
Desjonqueres E, Campani C, Marra F, et al. Preneoplastic lesions in the liver: molecular insights and relevance for clinical practice. Liver Int 2022;42:492–506.
Lendvai G, Szekerczés T, Illyés I, et al. Cholangiocarcinoma: classification, histopathology and molecular carcinogenesis. Pathol Oncol Res 2020;26:3–15.
Aslam A, Wasnik AP, Shi J, et al. Intraductal papillary neoplasm of the bile duct (IPNB): CT and MRI appearance with radiology–pathology correlation. Clin Imaging 2020;66(April):10–17.
IARC Publications. Digestive System Tumors WHO Classification of Tumours Series, 5th ed, Vol 1. International Agency for Research on Cancer; 2019.
Klöppel G, Adsay V, Konukiewitz B, et al. Precancerous lesions of the biliary tree. Best Pract Res Clin Gastroenterol 2013;27:285–297.
Rocha FG, Lee H, Katabi N, et al. Intraductal papillary neoplasm of the bile duct: a biliary equivalent to intraductal papillary mucinous neoplasm of the pancreas? Hepatology 2012;56:1352–1360.
Onoe S, Ebata T, Yokoyama Y, et al. A clinicopathological reappraisal of intraductal papillary neoplasm of the bile duct (IPNB): a continuous spectrum with papillary cholangiocarcinoma in 181 curatively resected cases. HPB 2021;23:1525–1532.
Kubota K, Jang JY, Nakanuma Y, et al. Clinicopathological characteristics of intraductal papillary neoplasm of the bile duct: a Japan–Korea collaborative study. J Hepatobiliary Pancreat Sci 2020;27:581–597.
Tan Y, Milikowski C, Toribio Y, et al. Intraductal papillary neoplasm of the bile ducts: a case report and literature review. World J Gastroenterol 2015;21:12498–12504.
Schlitter AM, Born D, Bettstetter M, et al. Intraductal papillary neoplasms of the bile duct: stepwise progression to carcinoma involves common molecular pathways. Mod Pathol 2014;27:73–86.
Van Roessel S, Mackay TM, Van Dieren S, et al. Textbook outcome: nationwide analysis of a novel quality measure in pancreatic surgery. Ann Surg 2020;271:155–162.
Mehta R, Tsilimigras DI, Paredes AZ, et al. Dedicated cancer centers are more likely to achieve a textbook outcome following hepatopancreatic surgery. Ann Surg Oncol 2020;27:1889–1897.
Merath K, Chen Q, Bagante F, et al. Textbook outcomes among medicare patients undergoing hepatopancreatic surgery. Ann Surg 2020;271:1116–1123.
Mathew G, Agha R. STROCSS Group. STROCSS 2021: strengthening the reporting of cohort, cross-sectional and case–control studies in surgery. Int J Surg 2021;96(November):106165.
Roffman CE, Buchanan J, Allison GT. Charlson comorbidities index. J Physiother 2016;62:171.
Halls MC, Berardi G, Cipriani F, et al. Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection. Br J Surg 2018;105:1182–1191.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–213.
Brooke-Smith M, Figueras J, Ullah S, et al. Prospective evaluation of the International Study Group for Liver Surgery definition of bile leak after a liver resection and the role of routine operative drainage: an international multicentre study. HPB 2015;17:46–51.
Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011;149:713–724.
Rahbari NN, Garden OJ, Padbury R, et al. Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS). HPB 2011;13:528–535.
Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 2017;161:584–591.
Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 2007;142:761–768.
Schlitter AM, Jang KT, Klöppel G, et al. Intraductal tubulopapillary neoplasms of the bile ducts: clinicopathologic, immunohistochemical, and molecular analysis of 20 cases. Mod Pathol 2015;28:1249–1264.
Zen Y, Pedica F, Patcha VR, et al. Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct. Mod Pathol 2011;24:1079–1089.
Campbell F, Cairns A, Duthie F, et al. Dataset for the histopathological reporting of carcinomas of the pancreas, ampulla of vater and common bile duct. The Royal College of Pathologists; 2017. www.rcpath.org
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–381.
Gyawali B, Eisenhauer E, Tregear M, et al. Progression-free survival: it is time for a new name. Lancet Oncol 2022;23:328–330.
Gordon-Weeks AN, Jones K, Harriss E, et al. Systematic review and meta-analysis of current experience in treating IPNB clinical and pathologica l corre lates. Ann Surg 2016;263:656–663.
Zen Y, Jang KT, Ahn S, et al. Intraductal papillary neoplasms and mucinous cystic neoplasms of the hepatobiliary system: demographic differences between Asian and Western populations, and comparison with pancreatic counterparts. Histopathology 2014;65:164–173.
D’Souza MA, Isaksson B, Löhr M, et al. The clinicopathological spectrum and management of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B). Scand J Gastroenterol 2013;48:473–479.
Woodhouse B, Panesar D, Koea J. Quality performance indicators for hepato-pancreatico-biliary procedures: a systematic review. HPB (Oxford) 2021;23:1–10.
Vibert E, Dokmak S, Belghiti J. Surgical strategy of biliary papillomatosis in Western countries. J Hepatobiliary Pancreat Sci 2010;17:241–245.
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 2019;43:1313–1322.
Kang MJ, Jang JY, Lee KB, et al. Impact of macroscopic morphology, multifocality, and mucin secretion on survival outcome of intraductal papillary neoplasm of the bile duct. J Gastrointest Surg 2013;17:931–938.
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Hepatobiliary Cancers, version 2; 2022. Accessed 24 August 2022. https://www.nccn.org/guidelines/recently-published-guidelines
Kim WJ, Hwang S, Lee YJ, et al. Clinicopathological features and long-term outcomes of intraductal papillary neoplasms of the intrahepatic bile duct. J Gastrointest Surg 2016;20:1368–1375.
Luvira V, Pugkhem A, Bhudhisawasdi V, et al. Long-term outcome of surgical resection for intraductal papillary neoplasm of the bile duct. J Gastroenterol Hepatol 2017;32:527–533.
Kim JR, Lee KB, Kwon W, et al. Comparison of the clinicopathologic characteristics of intraductal papillary neoplasm of the bile duct according to morphological and anatomical classifications. J Korean Med Sci 2018;33:e266.
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 2021;28:826–834.
Kim JR, Jang KT, Jang JY, et al. Clinicopathologic analysis of intraductal papillary neoplasm of bile duct: Korean multicenter cohort study. HPB (Oxford) 2020;22:1139–1148.