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Title: | Intraductal papillary neoplasms of the bile duct: a European retrospective multicenter observational study (EUR-IPNB study) | Authors: | Lluís, Núria Serradilla-Martín, Mario Achalandabaso, Mar Jehaes, François Dasari, Bobby V. M. Mambrilla-Herrero, Sara Sparrelid, Ernesto Balakrishnan, Anita Hoogwater, Frederik J. H. Amaral, Maria J. Andersson, Bodil Berrevoet, Frederik Doussot, Alexandre López-López, Víctor Alsammani, Mohammedsuror Detry, Olivier Domingo-Del Pozo, Carlos Machairas, Nikolaos Pekli, Damján Alcázar-López, Cándido F. Asbun, Horacio Björnsson, Bergthor Christophides, Thalis Díez-Caballero, Alberto Francart, David Noel, Colin B. Sousa-Silva, Donzília Toledo-Martínez, Enrique Tzimas, George N. Yaqub, Sheraz Cauchy, François Prieto-Calvo, Mikel D'Souza, Melroy A. Spiers, Harry V. M. van den Heuvel, Marius C. Charco, Ramón Lesurtel, Mickaël Ramia, José M. |
Keywords: | bile duct neoplasms; intraductal precursor lesion; pancreas; surgical resection; textbook outcome | Issue Date: | 1-Apr-2023 | Publisher: | Wolters Kluwer Health | Serial title, monograph or event: | International journal of surgery (London, England) | Volume: | 109 | Issue: | 4 | 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 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. | URI: | https://hdl.handle.net/10316/113490 | ISSN: | 1743-9159 | DOI: | 10.1097/JS9.0000000000000280 | Rights: | openAccess |
Appears in Collections: | FMUC Medicina - Artigos em Revistas Internacionais |
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