BACKGROUND: Peripheral cholangiocarcinoma (PCC) can be grossly classified into mass-forming, periductal-infiltrating, and intraductal papillary (IP) types. Information on IP-PCC patients undergoing hepatectomy is sparse because of the small number of cases. METHODS: The clinical features of 40 IP-PCC patients undergoing hepatectomy between 1977 and 2000 were reviewed. The clinical features of 94 PCC patients without IP growth undergoing hepatectomy were used for comparison. RESULTS: IP-PCC and non-IP-PCC groups had similar age distributions (P =.674), sex ratios (P =.079), and positive rates for serum carcinoembryonic antigen and CA 19-9 (P =.121 and.795, respectively). The two groups also exhibited similar rates of association between hepatolithiasis and PCC (P =.230). However, more IP-PCC patients exhibited signs during admission, and more had ALT values >36 IU/L; they also had smaller tumors, more mucobilia association, and tumors in earlier stages and had undergone more postoperative chemotherapy. Multivariate logistic regression analysis showed that only ALT >36 IU/L differentiated IP-PCC from non-IP-PCC patients. The two groups exhibited similar operative mortality (P = 1.0). Follow-up ranged from 1.6 to 125.2 months (mean and median, 44.6 and 5.7 months, respectively). The 1-, 3-, and 5-year overall survival rates were 72.9%, 41.2%, and 24.7%, respectively, in the IP-PCC group and 43.3, 6.03%, and 2.01% in the non-IP-PCC group. The prognosis was favorable for the IP-PCC patients (P <.00001), particularly for IP-PCC patients who received curative hepatectomy (P =.013). CONCLUSIONS: IP-PCC patients had significantly better survival than non-IP-PCC patients, and aggressive curative hepatic resection is associated with a longer survival.
BACKGROUND: Peripheral cholangiocarcinoma (PCC) can be grossly classified into mass-forming, periductal-infiltrating, and intraductal papillary (IP) types. Information on IP-PCCpatients undergoing hepatectomy is sparse because of the small number of cases. METHODS: The clinical features of 40 IP-PCCpatients undergoing hepatectomy between 1977 and 2000 were reviewed. The clinical features of 94 PCCpatients without IP growth undergoing hepatectomy were used for comparison. RESULTS:IP-PCC and non-IP-PCC groups had similar age distributions (P =.674), sex ratios (P =.079), and positive rates for serum carcinoembryonic antigen and CA 19-9 (P =.121 and.795, respectively). The two groups also exhibited similar rates of association between hepatolithiasis and PCC (P =.230). However, more IP-PCCpatients exhibited signs during admission, and more had ALT values >36 IU/L; they also had smaller tumors, more mucobilia association, and tumors in earlier stages and had undergone more postoperative chemotherapy. Multivariate logistic regression analysis showed that only ALT >36 IU/L differentiated IP-PCC from non-IP-PCCpatients. The two groups exhibited similar operative mortality (P = 1.0). Follow-up ranged from 1.6 to 125.2 months (mean and median, 44.6 and 5.7 months, respectively). The 1-, 3-, and 5-year overall survival rates were 72.9%, 41.2%, and 24.7%, respectively, in the IP-PCC group and 43.3, 6.03%, and 2.01% in the non-IP-PCC group. The prognosis was favorable for the IP-PCCpatients (P <.00001), particularly for IP-PCCpatients who received curative hepatectomy (P =.013). CONCLUSIONS:IP-PCCpatients had significantly better survival than non-IP-PCCpatients, and aggressive curative hepatic resection is associated with a longer survival.
Authors: Al B Benson; Thomas A Abrams; Edgar Ben-Josef; P Mark Bloomston; Jean F Botha; Bryan M Clary; Anne Covey; Steven A Curley; Michael I D'Angelica; Rene Davila; William D Ensminger; John F Gibbs; Daniel Laheru; Mokenge P Malafa; Jorge Marrero; Steven G Meranze; Sean J Mulvihill; James O Park; James A Posey; Jasgit Sachdev; Riad Salem; Elin R Sigurdson; Constantinos Sofocleous; Jean-Nicolas Vauthey; Alan P Venook; Laura Williams Goff; Yun Yen; Andrew X Zhu Journal: J Natl Compr Canc Netw Date: 2009-04 Impact factor: 11.908
Authors: Judith Meza-Junco; Aldo J Montano-Loza; Mang Ma; Winnie Wong; Michael B Sawyer; Vincent G Bain Journal: Can J Gastroenterol Date: 2010-01 Impact factor: 3.522