Shoji Kubo1, Shigekazu Takemura2, Shogo Tanaka2, Hiroji Shinkawa2, Masahiko Kinoshita2, Genya Hamano2, Tokuji Ito2, Masaki Koda2, Takanori Aota2, Takatsugu Yamamoto3, Hiroaki Terajima4, Gorou Tachiyama5, Terumasa Yamada6, Shoji Nakamori7, Akira Arimoto8, Masahiro Fujikawa9, Yoshito Tomimaru10, Yasuhiko Sugawara11, Kei Nakagawa12, Michiaki Unno12, Toru Mizuguchi13, Kenji Takenaka14, Koichi Kimura15, Ken Shirabe15, Akio Saiura16, Katsuhiko Uesaka17, Hiroki Taniguchi18, Akira Fukuda19, Ja-Mun Chong20, Yuko Kuwae21, Masahiko Ohsawa21, Yasunori Sato22, Yasuni Nakanuma23. 1. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m7696493@msic.med.osaka-cu.ac.jp. 2. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. 3. Department of Surgery, Ishikiriseiki Hospital, Higashi-osaka, Japan. 4. Department of Gastroenterological Surgery and Oncology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan. 5. Department of Surgery, Tane General Hospital, Osaka, Japan. 6. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 7. Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan. 8. Department of Hepato-Biliary-Pancreatic Surgery, Osaka Red Cross Hospital, Osaka, Japan. 9. Department of Surgery, Nissay Hospital, Osaka, Japan. 10. Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Japan. 11. Artificial Organ and Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan. 12. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 13. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan. 14. Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan. 15. Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 16. Department of Hepato-Biliary-Pancreatic Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan. 17. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan. 18. Department of Surgery, Kyoto Second Red Cross Hospital, Kyoto, Japan. 19. Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Toshima Hospital, Tokyo, Japan. 20. Department of Pathology, Tokyo Metropolitan Health and Medical Treatment Corporation Toshima Hospital, Tokyo, Japan. 21. Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan. 22. Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan. 23. Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
Abstract
BACKGROUND: Cholangiocarcinoma caused by exposure to 1,2-dichloropropane and/or dichloromethane is recognized as occupational cholangiocarcinoma. The aim of this study was to investigate the outcomes after resection of occupational cholangiocarcinoma to establish a treatment strategy for this disease. METHODS: Clinicopathological findings and outcomes after surgical intervention in 20 patients with occupational cholangiocarcinoma were investigated. RESULTS: Of 20 the patients, curative resection was performed in 16 patients. Three patients underwent radiation at the stump of the bile ducts. Adjuvant chemotherapy was performed in 12 patients. Biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and/or chronic bile duct injury was detected in most subjects. Intraabdominal infection developed after surgery in nine patients. Cholangiocarcinoma recurred in 12 of the 20 patients. The recurrent tumors in five patients developed at a different part of the bile duct from the primary tumor and a second resection was performed in four of these five patients. CONCLUSIONS: The incidence of postoperative complications including intraabdominal infection was high in patients with occupational cholangiocarcinoma. Multicentric recurrence occurred not infrequently after surgery because the bile ducts had a high potential for the development of carcinoma. The aggressive treatment including second resection for the multicentric recurrence appeared to be effective.
BACKGROUND:Cholangiocarcinoma caused by exposure to 1,2-dichloropropane and/or dichloromethane is recognized as occupational cholangiocarcinoma. The aim of this study was to investigate the outcomes after resection of occupational cholangiocarcinoma to establish a treatment strategy for this disease. METHODS: Clinicopathological findings and outcomes after surgical intervention in 20 patients with occupational cholangiocarcinoma were investigated. RESULTS: Of 20 the patients, curative resection was performed in 16 patients. Three patients underwent radiation at the stump of the bile ducts. Adjuvant chemotherapy was performed in 12 patients. Biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and/or chronic bile duct injury was detected in most subjects. Intraabdominal infection developed after surgery in nine patients. Cholangiocarcinoma recurred in 12 of the 20 patients. The recurrent tumors in five patients developed at a different part of the bile duct from the primary tumor and a second resection was performed in four of these five patients. CONCLUSIONS: The incidence of postoperative complications including intraabdominal infection was high in patients with occupational cholangiocarcinoma. Multicentric recurrence occurred not infrequently after surgery because the bile ducts had a high potential for the development of carcinoma. The aggressive treatment including second resection for the multicentric recurrence appeared to be effective.
Authors: Kyeong Min Kwak; Kyoung Sook Jeong; Dong Hoon Shin; Won-Jun Choi; Hyun Soo Kim; Seong-Kyu Kang Journal: Ind Health Date: 2018-07-03 Impact factor: 2.179