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Research Article
Clinicopathological difference between invasive pancreatic duct cancer and distal bile duct cancer of the pancreas head after pancreaticoduodenectomy
1 Department of Surgery, Kitaoka Hospital, 1031-5 Meiji-machi, Kurayoshi, Japan
2 Department of Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, Japan
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Masahide Ikeguchi
MD, Department of Surgery, Kitaoka Hospital, 1031-5 Meiji-machi, Kurayoshi 682-0887,
Japan
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Article ID: 100090Z04MI2020
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Ikeguchi M, Endo K. Clinicopathological difference between invasive pancreatic duct cancer and distal bile duct cancer of the pancreas head after pancreaticoduodenectomy. Int J Hepatobiliary Pancreat Dis 2020;10: 100090Z04MI2020.ABSTRACT
Aims: The only curative treatment for patients with invasive pancreatic duct cancer (IPDC) and distal bile duct cancer (DBDC) of the pancreas head is pancreaticoduodenectomy (PD). However, the clinicopathological difference between IPDC and DBDC after PD has not been thoroughly discussed. In this study, we retrospectively analyzed the clinical and pathological difference between IPDC and DBDC in patients who underwent PD.
Methods: Sixty-six patients who underwent curative PD were enrolled (IPDC, n = 35; DBDC, n = 31). Preoperative, intraoperative, and postoperative parameters and pathological factors (stages, lymph node metastasis, lymphatic invasion, vascular invasion, and perineural invasion) were compared.
Results: Jaundice was frequently detected and preoperative biliary drainage was frequently performed in patients with DBDC (60.5% and 90.3%, respectively). Additionally, the preoperative serum total bilirubin concentration and C-reactive protein/albumin ratio were higher in patients with DBDC than IPDC. As a result, the occurrence of postoperative pancreatic fistula occurred more frequently in patients with DBDC. In contrast, lymph node metastasis, lymphatic invasion, and vascular invasion were detected more frequently in patients with IPDC. The overall 5-year survival rate of the 35 patients with IPDC (13.4%) was much worse than that of the 31 patients with DBDC (52.3%, p < 0.001).
Conclusion: The oncological characteristics of IPDC are much different from those of DBDC. More effective treatment should be started in patients with IPDC as soon as possible.
Keywords: Distal bile duct cancer, Invasive pancreatic duct cancer, Pancreaticoduodenectomy, Prognosis
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Acknowledgments
We thank Angela Morben, DVM, ELS, from Edanz Group (https://en-author-services.edanzgroup.com/), for editing a draft of this manuscript.
Author ContributionsMasahide Ikeguchi - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Kanenori Endo - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Masahide Ikeguchi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
