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Intraductal papillary neoplasms of the bile duct : a European retrospective multicenter observational study (EUR-IPNB study)

Lluís, Núria ; Serradilla-Martín, Mario ; Achalandabaso, Mar ; Jehaes, François ; Dasari, Bobby V.M. ; Mambrilla-Herrero, Sara ; Sparrelid, Ernesto ; Balakrishnan, Anita ; Hoogwater, Frederik J.H. and Amaral, Maria J. , et al. (2023) In International journal of surgery (London, England) 109(4). p.760-771
Abstract

BACKGROUND/PURPOSE: 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: 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: A total of 28 centers contributed... (More)

BACKGROUND/PURPOSE: 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: 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: 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: 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.

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type
Contribution to journal
publication status
published
subject
in
International journal of surgery (London, England)
volume
109
issue
4
pages
12 pages
publisher
Elsevier
external identifiers
  • pmid:36917142
  • scopus:85153899786
ISSN
1743-9159
DOI
10.1097/JS9.0000000000000280
language
English
LU publication?
yes
id
c4ee8e41-c195-4f71-a56b-a0e2409bb2f4
date added to LUP
2023-09-20 14:40:41
date last changed
2024-04-19 01:29:23
@article{c4ee8e41-c195-4f71-a56b-a0e2409bb2f4,
  abstract     = {{<p>BACKGROUND/PURPOSE: 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: 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: 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: 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.</p>}},
  author       = {{Lluís, Núria and Serradilla-Martín, Mario and Achalandabaso, Mar and Jehaes, François and Dasari, Bobby V.M. and Mambrilla-Herrero, Sara and Sparrelid, Ernesto and Balakrishnan, Anita and Hoogwater, Frederik J.H. and Amaral, Maria J. and Andersson, Bodil and Berrevoet, Frederik and Doussot, Alexandre and López-López, Víctor and Alsammani, Mohammedsuror and Detry, Olivier and Domingo-Del Pozo, Carlos and Machairas, Nikolaos and Pekli, Damján and Alcázar-López, Cándido F. and Asbun, Horacio and Björnsson, Bergthor and Christophides, Thalis and Díez-Caballero, Alberto and Francart, David and Noel, Colin B. and Sousa-Silva, Donzília and Toledo-Martínez, Enrique and Tzimas, George N. and Yaqub, Sheraz and Cauchy, François and Prieto-Calvo, Mikel and D'Souza, Melroy A. and Spiers, Harry V.M. and van den Heuvel, Marius C. and Charco, Ramón and Lesurtel, Mickaël and Ramia, José M.}},
  issn         = {{1743-9159}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{4}},
  pages        = {{760--771}},
  publisher    = {{Elsevier}},
  series       = {{International journal of surgery (London, England)}},
  title        = {{Intraductal papillary neoplasms of the bile duct : a European retrospective multicenter observational study (EUR-IPNB study)}},
  url          = {{http://dx.doi.org/10.1097/JS9.0000000000000280}},
  doi          = {{10.1097/JS9.0000000000000280}},
  volume       = {{109}},
  year         = {{2023}},
}