Your browser doesn't support javascript.
loading
Oncologic Reappraisal of Bile Duct Resection for Middle-Third Cholangiocarcinoma.
Jikei, Kosuke; Ebata, Tomoki; Mizuno, Takashi; Kyokane, Takanori; Matsubara, Hideo; Yokoyama, Shinya; Kato, Kenji; Suzumura, Kiyoshi; Hashimoto, Mizuo; Kawai, Satoru; Nagino, Masato.
Afiliação
  • Jikei K; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  • Ebata T; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. tomoki@med.nagoya-u.ac.jp.
  • Mizuno T; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  • Kyokane T; Department of Surgery, Chutoen General Medical Center, Kakegawa, Japan.
  • Matsubara H; Department of Surgery, Yachiyo Hospital, Anjo, Japan.
  • Yokoyama S; Department of Surgery, Meijo Hospital, Nagoya, Japan.
  • Kato K; Department of Surgery, Inazawa Municipal Hospital, Inazawa, Japan.
  • Suzumura K; Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
  • Hashimoto M; Department of Surgery, Chubu-Rosai Hospital, Nagoya, Japan.
  • Kawai S; Department of Surgery, Tsushima City Hospital, Tsushima, Japan.
  • Nagino M; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ann Surg Oncol ; 28(4): 1990-1999, 2021 Apr.
Article em En | MEDLINE | ID: mdl-32960392
BACKGROUND: Although bile duct resection (BDR) in addition to pancreaticoduodenectomy (PD) is considered a surgical approach in patients with middle-third cholangiocarcinoma (MCC), available prognostic information after BDR remains very limited. The aim of this study was to reappraise BDR from the viewpoint of surgical oncology. METHODS: Patients who underwent BDR or PD for MCC between 2001 and 2010 at 32 Japanese hospitals were included. Clinicopathological factors were retrospectively compared according to surgical procedure to identify a subset cohort who benefited most from BDR. RESULTS: During the study, 92 patients underwent BDR (n = 38) or PD (n = 54). BDR was characterized by a shorter operation time, less blood loss, less frequent complications, and lower mortality, than PD. The incidence of positive surgical margins was 26.3% versus 5.6% (P = 0.007). The survival rate after BDR was significantly worse than that after PD: 38.8% versus 54.8% at 5 years (P = 0.035), and BDR was independently associated with deteriorated survival [hazard ratio (HR), 1.76; P = 0.023] by multivariable analysis. In the BDR group, tumor length < 15 mm (HR, 3.38; P = 0.017) and ductal margin length ≥ 10 mm (HR, 2.54; P = 0.018) were independent positive prognostic factors. Stratified by these two favorable factors, the 5-year survival rate was 63.0% in patients with 1/2 factors and 6.7% in those with 0 factors (P < 0.001). CONCLUSION: In patients with MCC, BDR provided a better short-term and a worse long-term outcome than PD. However, patient selection using tumor length and ductal margin length may allow a favorable survival probability even after BDR.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias dos Ductos Biliares / Colangiocarcinoma Tipo de estudo: Observational_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Ann Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias dos Ductos Biliares / Colangiocarcinoma Tipo de estudo: Observational_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Ann Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão