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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

Survival and tumor location. Survival was related to tumor location. Gallbladder carcinoma had significantly worse prognosis than cholangiocarcinoma (p = 0.001). There was no significant difference between intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) while both had significantly better survival than gallbladder carcinoma. Median survival of gallbladder cancer was about 8 months, for ICC 20 months, for ECC 22 months.
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Figure 7: Survival and tumor location. Survival was related to tumor location. Gallbladder carcinoma had significantly worse prognosis than cholangiocarcinoma (p = 0.001). There was no significant difference between intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) while both had significantly better survival than gallbladder carcinoma. Median survival of gallbladder cancer was about 8 months, for ICC 20 months, for ECC 22 months.

Mentions: Survival in carcinoma of the gallbladder was significantly worse than survival in ductal cholangiocarcinoma (p = 0.001) as shown in Figure 7. This was also true when either intrahepatic or extrahepatic cholangiocarcinoma was compared separately with gallbladder carcinoma. Survival of intrahepatic versus extrahepatic cholangiocarcinoma was not significantly different with a minimal advantage for extrahepatic disease (data not shown).


Is an aggressive surgical approach worthwhile in biliary cancer?

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

Survival and tumor location. Survival was related to tumor location. Gallbladder carcinoma had significantly worse prognosis than cholangiocarcinoma (p = 0.001). There was no significant difference between intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) while both had significantly better survival than gallbladder carcinoma. Median survival of gallbladder cancer was about 8 months, for ICC 20 months, for ECC 22 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: Survival and tumor location. Survival was related to tumor location. Gallbladder carcinoma had significantly worse prognosis than cholangiocarcinoma (p = 0.001). There was no significant difference between intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) while both had significantly better survival than gallbladder carcinoma. Median survival of gallbladder cancer was about 8 months, for ICC 20 months, for ECC 22 months.
Mentions: Survival in carcinoma of the gallbladder was significantly worse than survival in ductal cholangiocarcinoma (p = 0.001) as shown in Figure 7. This was also true when either intrahepatic or extrahepatic cholangiocarcinoma was compared separately with gallbladder carcinoma. Survival of intrahepatic versus extrahepatic cholangiocarcinoma was not significantly different with a minimal advantage for extrahepatic disease (data not shown).

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