Comparative Study of Papillary Carcinomas and Conventional Adenocarcinomas of the Extrahepatic Bile Ducts. A Study of 5870 Cases from the SEER Program of the National Cancer Institute
Jorge Albores-Saavedra, Amy Shah, Fredy Chable-Montero, Donald E Henson. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán and Medica Sur Clinic and Foundation, México City, DF, Mexico; The George Washington University Cancer Institute, Washington, DC
Background: Papillary carcinomas of the extrahepatic bile ducts are a controversial entity, because they have been compared to intraductal papillary mucinous neoplasms of the pancreas which are low-grade malignant tumors. However, some authors based on small series considered that both conventional adenocarcinomas and papillary carcinomas are high-grade malignant tumors.
Design: From 1973 to 2008 we reviewed all papillary carcinomas and conventional adenocarcinomas of the extrahepatic bile ducts collected by the SEER program of the National Cancer Institute and compared their demographics and long term survival rates.
Results: There were a total of 5870 cases of which 5582 (95.1%) were conventional adenocarcinomas and 288 (4.9%) were papillary carcinomas. Of these, 285 (99%) were invasive and 3 non-invasive carcinomas. There has been a decrease in the incidence of papillary carcinoma since 1973, while the incidence of conventional adenocarcinoma has been stable. There was a 77.2% decrease in the rate from 1973-2008, which is statistically significant. Overall, the 5-year survival rate of papillary carcinomas was 10%, similar to the 5-year survival rate of conventional adenocarcinomas. Localized papillary carcinomas (confined to the wall) had a 5-year survival rate of 30% while the localized conventional adenocarcinomas had a 20% 5-year survival rate. The difference was not statistically significant.
Conclusions: The vast majority of papillary carcinomas of the extrahepatic bile ducts are invasive (99%) and the 5-year survival rate is similar to that of conventional adenocarcinomas. Papillary carcinomas of the extrahepatic bile ducts are high-grade malignant neoplasms. The reason for the decrease incidence of papillary carcinoma is unknown.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 75, Wednesday Morning