Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Clinicopathological characteristics of extrahepatic biliary neuroendocrine neoplasms in the gallbladder, extrahepatic biliary tract, and ampulla of Vater: A single-center cross-sectional study

  • Young Mok Park (Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Hyung Il Seo (Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Byeong Gwan Noh (Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Suk Kim (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Seung Baek Hong (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Nam Kyung Lee (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Dong Uk Kim (Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Sung Yong Han (Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine)
  • Received : 2023.03.28
  • Accepted : 2023.06.06
  • Published : 2023.11.30
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Abstract

Backgrounds/Aims: In 2019, the grading and staging system for neuroendocrine neoplasms (NENs) was significantly changed. In this study, we report the clinicopathological characteristics and surgical outcomes of patients with extrahepatic biliary NENs who underwent curative resection with or without adjuvant treatment. Methods: We retrospectively reviewed a database of 16 patients who developed NENs, neuroendocrine carcinoma (NEC), and mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight patients had ampulla of Vater (AoV) tumors, and eight patients had non-AoV tumors. Results: G1 and G2 were more frequently observed in the AoV group than in the non-AoV group (12.5% and 62.5%, respectively). In contrast, NEC and MiNEN were more common in the non-AoV group (50.0%). High Ki-67 index (> 20%) and perineural invasion (PNI) were more frequently observed in the non-AoV group. Advanced age (> 65 years), mitotic count > 20 per 2 mm2, and Ki-67 index > 20% were strongly correlated with patient survival (p = 0.018, 0.009, and 0.044, respectively). Advanced age (> 65 years) and mitotic count > 20 per 2 mm2 were significantly correlated with disease recurrence (p = 0.033 and 0.010, respectively). Conclusions: AoV and non-AoV tumors had significant differences in the histologic grade, Ki67, and PNI. Patients with non-AoV tumors had an increased risk for survival and recurrence than those in the AoV group. For extrahepatic biliary NENs, early detection of tumors, adequate surgery, and aggressive adjuvant treatment for high-risk patients are important to achieve long-term survival and prevent disease recurrence.

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