Long-term survival after palliative argon plasma coagulation for intraductal papillary mucinous neoplasm of the bile duct

Arai, Junya; Kato, Jun; Toda, Nobuo; Kurokawa, Ken; Shibata, Chikako; Kurosaki, Shigeyuki; Funato, Kazuyoshi; Kondo, Mayuko; Takagi, Kaoru; Kojima, Kentaro; Ohki, Masataka; Seki, Michiharu; Tagawa, Kunio

doi:10.1007/s12328-020-01199-0

Cited by 7 publications

(9 citation statements)

References 16 publications

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“…Partial hepatectomy followed by palliative chemotherapy has also been reported [ 160 ]. Recently, the treatment of IPNB using argon plasma coagulation with a follow-up period of more than two years was newly reported [ 161 ].…”

Section: The Diagnosis Treatment and Prognosis Including The Posmentioning

confidence: 99%

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Nakanuma

Uesaka

Kakuda

et al. 2020

JCM

113

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Intraductal papillary neoplasm of the bile duct (IPNB), a pre-invasive neoplasm of the bile duct, is being established pathologically as a precursor lesion of invasive cholangiocarcinoma (CCA), and at the time of surgical resection, approximately half of IPNBs show stromal invasion (IPNB associated with invasive carcinoma). IPNB can involve any part of the biliary tree. IPNB shows grossly visible, exophytic growth in a dilated bile duct lumen, with histologically villous/papillary neoplastic epithelia with tubular components covering fine fibrovascular stalks. Interestingly, IPNB can be classified into four subtypes (intestinal, gastric, pancreatobiliary and oncocytic), similar to intraductal papillary mucinous neoplasm of the pancreas (IPMN). IPNBs are classified into low-grade and high-grade based on lining epithelial features. The new subclassification of IPNB into types 1 (low-grade dysplasia and high-grade dysplasia with regular architecture) and 2 (high-grade dysplasia with irregular architecture) proposed by the Japan–Korea pathologist group may be useful in the clinical field. The outcome of post-operative IPNBs is more favorable in type 1 than type 2. Recent genetic studies using next-generation sequencing have demonstrated the existence of several groups of mutations of genes: (i) IPNB showing mutations in KRAS, GNAS and RNF43 belonged to type 1, particularly the intestinal subtype, similar to the mutation patterns of IPMN; (ii) IPNB showing mutations in CTNNB1 and lacking mutations in KRAS, GNAS and RNF43 belonged to the pancreatobiliary subtype but differed from IPMN. IPNB showing mutation of TP53, SMAD4 and PIK3CA might reflect complicated and other features characterizing type 2. The recent recognition of IPNBs may facilitate further clinical and basic studies of CCA with respect to the pre-invasive and early invasive stages.

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Section: The Diagnosis Treatment and Prognosis Including The Posmentioning

confidence: 99%

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Nakanuma

Uesaka

Kakuda

et al. 2020

JCM

113

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“…There is no established treatment strategy for patients who are difficult to treat, but additional treatment should be considered. As mentioned above, many methods have been recently reported for local treatment, including PDT, RFA, and APC, in IPNB [ 6 , 7 , 8 , 9 ]. Although there is still a need for studies on the safety and effectiveness of these local treatments, they are thought to be options for patients with non-malignant I-IPNB for whom it will be difficult to perform surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there are no known factors predicting malignancy, but if these factors could be identified, they would be useful in deciding the need for surgical treatment for I-IPNB. Recently, some cases of local treatment, such as radiofrequency ablation (RFA), photodynamic therapy (PDT), and argon plasma coagulation (APC), have been reported in patients who are difficult to treat [ 6 , 7 , 8 , 9 ]. Although long-term results have not been obtained, these local treatments could be performed in patients with a low risk for malignancy and in those who are not suitable for surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Malignant Predictors in Intrahepatic and Extrahepatic Intraductal Papillary Neoplasm of the Bile Duct

Han

Kim

Nam

et al. 2022

JCM

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Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a precancerous lesion of cholangiocarcinoma, for which surgical resection is the most effective treatment. We evaluated the predictors of malignancy in IPNB according to anatomical location and the prognosis without surgery. Methods: A total of 196 IPNB patients who underwent pathologic confirmation by surgical resection or endoscopic retrograde cholangiography or percutaneous transhepatic cholangioscopic biopsy were included. Clinicopathological findings of IPNB with invasive carcinoma or mucosal dysplasia were analyzed according to anatomical location. Results: Of the 116 patients with intrahepatic IPNB (I-IPNB) and 80 patients with extrahepatic IPNB (E-IPNB), 62 (53.4%) and 61 (76.3%) were diagnosed with invasive carcinoma, respectively. Multivariate analysis revealed that mural nodule > 12 mm (p = 0.043) in I-IPNB and enhancement of mural nodule (p = 0.044) in E-IPNB were predictive factors for malignancy. For pathologic discrepancy before and after surgery, IPNB has a 71.2% sensitivity and 82.3% specificity. In the non-surgical IPNB group, composed of nine I-IPNB and seven E-IPNB patients, 43.7% progressed to IPNB with invasive carcinoma within 876 days. Conclusions: E-IPNB has a higher rate of malignancy than I-IPNB. The predictive factor for malignancy is mural nodule > 12 mm in I-IPNB and mural nodule enhancement in E-IPNB.

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“…However, liver transplantation is unsuitable for patients with advanced tumor invasion or positive lymph nodes ( 4 ). Recently, new approaches, such as RFA and APC, have been helpful for patients who are not candidates for surgery due to age or physical condition ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

“…To further investigate the clinical features and prognosis of IPNB, we gathered case reports of IPNB in PubMed ( 17 – 55 ). We searched PubMed for “Intraductal papillary neoplasm of the bile duct” and “case report” during 2002 to 2021.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Intraductal Papillary Neoplasm of the Bile Duct: A Report of Two Cases and Review of the Literature

Liu

Zhang

et al. 2022

Front. Oncol.

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Intraductal papillary neoplasm of the bile duct (IPNB) is a rare bile duct tumor characterized by intraductal papillary or villous neoplasms covered by neoplastic epithelium with fine fibrovascular stalks in the dilated bile ducts (1). Its true etiology remains unknown. Herein, we report two cases of IPNB that underwent surgical resection. The first case was a 66-year-old male who complained of upper abdominal pain for three years. We found obstruction of the common bile duct and dilation of the intrahepatic and extrahepatic bile ducts after MRCP. Laparoscopic hepatic segmentectomy (S2, S3, S4), resection of the common bile duct, cholecystectomy, and hepaticojejunostomy were performed. The second case was a 67-year-old male with asymptomatic dilation of the intrahepatic duct. The patient underwent robot-assisted laparoscopic hepatic segmentectomy (S5, S6, S7, S8), resection of the common bile duct, hepaticojejunostomy and cholecystectomy.

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Long-term survival after palliative argon plasma coagulation for intraductal papillary mucinous neoplasm of the bile duct

Cited by 7 publications

References 16 publications

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Comparison of the Malignant Predictors in Intrahepatic and Extrahepatic Intraductal Papillary Neoplasm of the Bile Duct

Surgical Treatment of Intraductal Papillary Neoplasm of the Bile Duct: A Report of Two Cases and Review of the Literature

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