Limits...
Is an aggressive surgical approach worthwhile in biliary cancer?

Ristagno N, Knuth A, Pestalozzi BC - Int Semin Surg Oncol (2007)

Bottom Line: Patients undergoing resection during the second time period were more likely to be without relapse compared with patients undergoing resection in the first time period.Resected patients had better survival compared with unresected patients for all tumor locations (gallbladder, extrahepatic and intrahepatic cholangiocarcinomas).Overall survival of patients was not significantly different between patients treated during the first versus the second time period.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oncology, University Hospital, Raemistrasse 100, 8091 Zürich, Switzerland. bernhard.pestalozzi@usz.ch.

ABSTRACT

Background: Biliary cancer includes cancer of the gallbladder as well as extrahepatic and intrahepatic cholangiocarcinoma. Surgery is the only curative treatment option available. Recently, much more aggressive surgical approaches have been employed. Therefore, we have investigated outcome of biliary cancer before and after establishment of an aggressive surgical approach.

Methods: Retrospective single-center analysis comparing two time periods of 5 years each. During the second period new surgical expertise and a much more aggressive surgical approach were used.

Results: In the first time period (5/1995-4/2000) only 29 patients with biliary cancer were treated at our institution, while a total of 85 patients were treated during the second time period (5/2000-4/2005). Surgical resection was attempted in 55% during the first period versus 62% in the second; resection was complete in 37.5% and 58.5%, respectively. Patients undergoing resection during the second time period were more likely to be without relapse compared with patients undergoing resection in the first time period. No patient from the first period is without evidence of disease, compared to 11 patients operated in the second period. Resected patients had better survival compared with unresected patients for all tumor locations (gallbladder, extrahepatic and intrahepatic cholangiocarcinomas). Overall survival of patients was not significantly different between patients treated during the first versus the second time period.

Conclusion: In patients with biliary cancer surgical resection should be attempted whenever possible. However, long-term survival can be achieved only when a complete resection is obtained.

No MeSH data available.


Related in: MedlinePlus

Resection and survival. Survival of patients undergoing resection was significantly increased compared with patients not undergoing resection (p = 0.000). This is shown for all patients. It was also true for patients of the first time period (N = 29), and for patients of the second time period (N = 85).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2211286&req=5

Figure 3: Resection and survival. Survival of patients undergoing resection was significantly increased compared with patients not undergoing resection (p = 0.000). This is shown for all patients. It was also true for patients of the first time period (N = 29), and for patients of the second time period (N = 85).

Mentions: Overall survival in resected patients is significantly longer than in non-resected patients (p = 0.000) as shown in Figure 3. This was true and very alike for both time periods (data not shown). Taking a close look at Figure 3 shows that no un-resected patient has survived 3 years, while more than 30% of resected patients are alive at the 3-year time interval.


Is an aggressive surgical approach worthwhile in biliary cancer?

Ristagno N, Knuth A, Pestalozzi BC - Int Semin Surg Oncol (2007)

Resection and survival. Survival of patients undergoing resection was significantly increased compared with patients not undergoing resection (p = 0.000). This is shown for all patients. It was also true for patients of the first time period (N = 29), and for patients of the second time period (N = 85).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2211286&req=5

Figure 3: Resection and survival. Survival of patients undergoing resection was significantly increased compared with patients not undergoing resection (p = 0.000). This is shown for all patients. It was also true for patients of the first time period (N = 29), and for patients of the second time period (N = 85).
Mentions: Overall survival in resected patients is significantly longer than in non-resected patients (p = 0.000) as shown in Figure 3. This was true and very alike for both time periods (data not shown). Taking a close look at Figure 3 shows that no un-resected patient has survived 3 years, while more than 30% of resected patients are alive at the 3-year time interval.

Bottom Line: Patients undergoing resection during the second time period were more likely to be without relapse compared with patients undergoing resection in the first time period.Resected patients had better survival compared with unresected patients for all tumor locations (gallbladder, extrahepatic and intrahepatic cholangiocarcinomas).Overall survival of patients was not significantly different between patients treated during the first versus the second time period.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oncology, University Hospital, Raemistrasse 100, 8091 Zürich, Switzerland. bernhard.pestalozzi@usz.ch.

ABSTRACT

Background: Biliary cancer includes cancer of the gallbladder as well as extrahepatic and intrahepatic cholangiocarcinoma. Surgery is the only curative treatment option available. Recently, much more aggressive surgical approaches have been employed. Therefore, we have investigated outcome of biliary cancer before and after establishment of an aggressive surgical approach.

Methods: Retrospective single-center analysis comparing two time periods of 5 years each. During the second period new surgical expertise and a much more aggressive surgical approach were used.

Results: In the first time period (5/1995-4/2000) only 29 patients with biliary cancer were treated at our institution, while a total of 85 patients were treated during the second time period (5/2000-4/2005). Surgical resection was attempted in 55% during the first period versus 62% in the second; resection was complete in 37.5% and 58.5%, respectively. Patients undergoing resection during the second time period were more likely to be without relapse compared with patients undergoing resection in the first time period. No patient from the first period is without evidence of disease, compared to 11 patients operated in the second period. Resected patients had better survival compared with unresected patients for all tumor locations (gallbladder, extrahepatic and intrahepatic cholangiocarcinomas). Overall survival of patients was not significantly different between patients treated during the first versus the second time period.

Conclusion: In patients with biliary cancer surgical resection should be attempted whenever possible. However, long-term survival can be achieved only when a complete resection is obtained.

No MeSH data available.


Related in: MedlinePlus