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Intrapancreatic distal common bile duct carcinoma: Analysis, staging considerations, and comparison with pancreatic ductal and ampullary adenocarcinomas

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dc.contributor.authorBAĞCI ÇULÇİ, PELİN
dc.contributor.authorsGonzalez, Raul S.; Bagci, Pelin; Basturk, Olca; Reid, Michelle D.; Balci, Serdar; Knight, Jessica H.; Kong, So Yeon; Memis, Bahar; Jang, Kee-Taek; Ohike, Nobuyuki; Tajiri, Takuma; Bandyopadhyay, Sudeshna; Krasinskas, Alyssa M.; Kim, Grace E.; Cheng, Jeanette D.; Adsay, N. Volkan
dc.date.accessioned2022-03-14T08:16:35Z
dc.date.available2022-03-14T08:16:35Z
dc.date.issued2016-11
dc.description.abstractDistal common bile duct carcinoma is a poorly characterized entity for reasons such as variable terminology and difficulty in determining site of origin of intrapancreatic lesions. We compared clinicopathologic features of pancreatobiliary-type adenocarcinomas within the pancreas, but arising from the distal common bile duct, with those of pancreatic and ampullary origin. Upon careful review of 1017 pancreatoduodenectomy specimens with primary adenocarcinoma, 52 (5%) qualified as intrapancreatic distal common bile duct carcinoma. Five associated with an intraductal papillary neoplasm were excluded; the remaining 47 were compared to 109 pancreatic ductal adenocarcinomas and 133 ampullary carcinomas. Distal common bile duct carcinoma patients had a younger median age (58 years) than pancreatic ductal adenocarcinoma patients (65 years) and ampullary carcinoma patients (68 years). Distal common bile duct carcinoma was intermediate between pancreatic ductal adenocarcinoma and ampullary carcinoma with regard to tumor size and rates of node metastases and margin positivity. Median survival was better than for pancreatic ductal adenocarcinoma (P=0.0010) but worse than for ampullary carcinoma (P=0.0006). Distal common bile duct carcinoma often formed an even band around the common bile duct and commonly showed intraglandular neutrophil-rich debris and a small tubular pattern. Poor prognostic indicators included node metastasis (P=0.0010), lymphovascular invasion (P=0.0299), and margin positivity (P=0.0069). Categorizing the tumors based on size also had prognostic relevance (P=0.0096), unlike categorization based on anatomic structures invaded. Primary distal common bile duct carcinoma is seen in younger patients than pancreatic ductal adenocarcinoma or ampullary carcinoma. Its prognosis is significantly better than pancreatic ductal adenocarcinoma and worse than ampullary carcinoma, at least partly because of differences in clinical presentation. Use of size-based criteria for staging appears to improve its prognostic relevance. Invasive pancreatobiliary-type distal common bile duct carcinomas are uncommon in the West and have substantial clinicopathologic differences from carcinomas arising from the pancreas and ampulla.
dc.identifier.doi10.1038/modpathol.2016.125
dc.identifier.eissn1530-0285
dc.identifier.issn0893-3952
dc.identifier.pubmed27469329
dc.identifier.urihttps://hdl.handle.net/11424/241389
dc.identifier.wosWOS:000386404800007
dc.language.isoeng
dc.publisherNATURE PUBLISHING GROUP
dc.relation.ispartofMODERN PATHOLOGY
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPAPILLARY MUCINOUS NEOPLASM
dc.subjectMULTIVARIATE STATISTICAL-ANALYSIS
dc.subjectFACTORS INFLUENCING SURVIVAL
dc.subjectINTRAEPITHELIAL NEOPLASIA
dc.subjectSINGLE INSTITUTION
dc.subjectPROGNOSTIC-FACTORS
dc.subject5-YEAR SURVIVORS
dc.subjectT-CLASSIFICATION
dc.subjectLYMPH-NODES
dc.subjectSOFT-TISSUE
dc.titleIntrapancreatic distal common bile duct carcinoma: Analysis, staging considerations, and comparison with pancreatic ductal and ampullary adenocarcinomas
dc.typearticle
dspace.entity.typePublication
local.avesis.idad9d77d7-1289-4d60-ae7f-8746c14017b2
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages12
local.journal.quartileQ1
oaire.citation.endPage1369
oaire.citation.issue11
oaire.citation.startPage1358
oaire.citation.titleMODERN PATHOLOGY
oaire.citation.volume29
relation.isAuthorOfPublication08d32d97-3eab-4e66-9cb5-3177601d83e9
relation.isAuthorOfPublication.latestForDiscovery08d32d97-3eab-4e66-9cb5-3177601d83e9

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