Superficial vs deep pancreatic parenchymal invasion in the extrahepatic bile duct carcinomas: a significant prognostic factor

Abstract

Pancreatic invasion of the extrahepatic bile duct (EBD) carcinomas is known to have a poor outcome. We hypothesized that EBD carcinoma showing shallow invasion to the pancreas may have a better outcome than the usual deep pancreatic invasion. We divided 87 cases of the distal EBD carcinomas into superficial and deep pancreatic invasion groups according to degrees of the pancreatic invasion. The superficial pancreatic invasion group included cases with tumor abutting the pancreatic lobule or pancreatic parenchymal invasion equal to or less than 1 mm from the uppermost portion of the pancreatic lobule or tumors invading into the fibroadipose tissue between pancreatic lobules without parenchymal invasion. The deep invasion group consisted of tumors with more than 1 mm pancreatic parenchymal invasion. The cases with superficial pancreatic invasion showed significantly better survival rate than those with deep pancreatic invasion (Po0.001). Therefore, we recommend that a specific remark on the pathology report about the presence or absence of parenchymal invasion and the depth of invasion of the pancreas is required for managing patients and determining the prognosis. We also recommend that the current pT3 stage of distal EBD carcinomas be subdivided into superficial (pT3a) and deep pancreatic invasion (pT3b). Modern Pathology (2005) 18, 969-975.

Decreased expression of focal adhesion kinase is associated with a poor prognosis in extrahepatic bile duct carcinoma

“…Previous studies have shown some prognostic factors, such as resection margin [23], lymph node metastasis [24], and pancreatic parenchymal invasion [25]. Furthermore, some molecules, including KIT [26], epidermal growth factor receptor (EGFR) [27], Caveolin-I [28], and MUC4 [29], were revealed to be prognostic factors of EBD carcinomas, but FAK expression in EBD carcinomas has not been evaluated.…”

Portal Vein Resection in Surgery for Cancer of Biliary Tract and Pancreas: Special Reference to the Relationship Between the Surgical Outcome and Site of Primary Tumor

“…In middle and distal cholangiocarcinoma, tumors with deep invasion were associated with poor prognosis compared with those with superficial invasion. 53 Furthermore, the depth of invasion of the primary tumor correlated well with patient survival in middle and distal cholangiocarcinoma, whereas it did not in hilar lesion. 54 Considering these biological characteristics, portal vein invasion in these lesions should be regarded as the depth of invasion of the primary tumor.…”

Prognostic Factors Associated with Preoperative Clinicophysiological Outcomes of Distal Cholangiocarcinoma

“…For example, Saito et al [23] reported the identification of 4 independent factors -a serum CEA level >7.0 ng/mL, Alb level <3.5 g/dL, CRP level >0.5 mg/dL, and PLR >150 -that could be measured preoperatively and used to predict the prognosis of patients with perihilar cholangiocarcinoma. Table 4 summarizes recent reports that identified lymph node metastasis, stage, GPS, and tumor differentiation as prognostic factors of distal cholangiocarcinoma [8,[15][16][17][18][19][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] .…”