BACKGROUND: The differences between perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC) regarding recurrence and the factors that affect recurrence after surgery are unclear. This study aims to investigate the differences in recurrence patterns between patients with PHCC and those with DCC after surgical resection with curative intent. It also investigates the risk factors associated with recurrence and survival thereafter. PATIENTS AND METHODS: The postoperative courses of 366 patients with extrahepatic cholangiocarcinomas (EHCCs), including 236 with PHCC and 130 with DCC, who underwent surgical resections were investigated retrospectively. RESULTS: During follow-up, tumors recurred in 143 (60.6%) patients with PHCC and in 72 (55.4%) patients with DCC. Overall survival (OS) after surgery, recurrence-free survival (RFS), and OS after recurrence were similar for the patients with PHCC and those with DCC. The cumulative probability of recurrence declined 3 years after surgery in the patients with PHCC and those with DCC. A multivariable analysis determined that, among the patients with PHCC and those with DCC, regional lymph node metastasis was a significant risk factor associated with RFS. Ten patients with PHCC and eight patients with DCC with two or fewer sites of recurrence in a single organ underwent resections. A multivariable analysis determined that recurrent tumor resection was an independent prognostic factor associated with OS after recurrence in the patients with PHCC and those with DCC. CONCLUSIONS: Postoperative survival did not differ between the patients with PHCC and those with DCC. Frequent surveillances for recurrence are needed for 3 years after surgical resection of EHCCs. In selected patients, surgery for recurrent EHCCs might be associated with improved outcomes.
BACKGROUND: The differences between perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC) regarding recurrence and the factors that affect recurrence after surgery are unclear. This study aims to investigate the differences in recurrence patterns between patients with PHCC and those with DCC after surgical resection with curative intent. It also investigates the risk factors associated with recurrence and survival thereafter. PATIENTS AND METHODS: The postoperative courses of 366 patients with extrahepatic cholangiocarcinomas (EHCCs), including 236 with PHCC and 130 with DCC, who underwent surgical resections were investigated retrospectively. RESULTS: During follow-up, tumors recurred in 143 (60.6%) patients with PHCC and in 72 (55.4%) patients with DCC. Overall survival (OS) after surgery, recurrence-free survival (RFS), and OS after recurrence were similar for the patients with PHCC and those with DCC. The cumulative probability of recurrence declined 3 years after surgery in the patients with PHCC and those with DCC. A multivariable analysis determined that, among the patients with PHCC and those with DCC, regional lymph node metastasis was a significant risk factor associated with RFS. Ten patients with PHCC and eight patients with DCC with two or fewer sites of recurrence in a single organ underwent resections. A multivariable analysis determined that recurrent tumor resection was an independent prognostic factor associated with OS after recurrence in the patients with PHCC and those with DCC. CONCLUSIONS: Postoperative survival did not differ between the patients with PHCC and those with DCC. Frequent surveillances for recurrence are needed for 3 years after surgical resection of EHCCs. In selected patients, surgery for recurrent EHCCs might be associated with improved outcomes.
Authors: John N Primrose; Richard P Fox; Daniel H Palmer; Hassan Z Malik; Raj Prasad; Darius Mirza; Alan Anthony; Pippa Corrie; Stephen Falk; Meg Finch-Jones; Harpreet Wasan; Paul Ross; Lucy Wall; Jonathan Wadsley; Jeff T R Evans; Deborah Stocken; Raaj Praseedom; Yuk Ting Ma; Brian Davidson; John P Neoptolemos; Tim Iveson; James Raftery; Shihua Zhu; David Cunningham; O James Garden; Clive Stubbs; Juan W Valle; John Bridgewater Journal: Lancet Oncol Date: 2019-03-25 Impact factor: 41.316
Authors: Bas Groot Koerkamp; Jimme K Wiggers; Peter J Allen; Marc G Besselink; Leslie H Blumgart; Olivier R C Busch; Robert J Coelen; Michael I D'Angelica; Ronald P DeMatteo; Dirk J Gouma; T Peter Kingham; William R Jarnagin; Thomas M van Gulik Journal: J Am Coll Surg Date: 2015-09-15 Impact factor: 6.113
Authors: Lynn E Nooijen; Jesus M Banales; Marieke T de Boer; Chiara Braconi; Trine Folseraas; Alejandro Forner; Waclaw Holowko; Frederik J H Hoogwater; Heinz-Josef Klümpen; Bas Groot Koerkamp; Angela Lamarca; Adelaida La Casta; Flora López-López; Laura Izquierdo-Sánchez; Alexander Scheiter; Kirsten Utpatel; Rutger-Jan Swijnenburg; Geert Kazemier; Joris I Erdmann Journal: Cancers (Basel) Date: 2022-05-12 Impact factor: 6.575