Long-term prognosis after surgical resection of intraductal papillary neoplasm of the bile ducts

Abstract

Description of clinicopathological issues and classification of intraductal papillary neoplasm of the bile ducts (IPNB) were revised in WHO classification of tumours (5th edition). The new classification of Type 1 (classical IPNB) and type 2 (so-called papillary carcinoma or cholangiocarcinoma) advocated by the Japan-Korea collaborative study were also introduced in the 5th edition. Long-term prognosis after surgical resection of IPNB with a 5-year survival rate of around 50% to 80% is better than that of ordinary cholangiocarcinoma. The main prognostic factors are positivity of surgical margins, tumor location (extrahepatic), invasion, lymph node metastasis, Type 2, pancreatobiliary phenotype, and positivity for MUC1. Caution should be paid for specific recurrence patterns during postoperative follow-up such as metachronous multiplicity and implantation.