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Clinical features and survival outcome of locally advanced extrahepatic cholangiocarcinoma.

Lee SJ, Kwon W, Kang MJ, Jang JY, Chang YR, Jung W, Kim SW - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively.For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001).Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Little is known about clinical features and survival outcome in locally advanced unresectable extrahepatic cholangiocarcinoma (EHC). The aim was to investigate the clinical features and the survival outcome in these patients, and to evaluate the role of palliative resections in locally advanced unresectable EHC.

Methods: Between 1995 and 2007, 280 patients with locally advanced unresectable EHC were identified. Clinical, pathologic, and survival data were investigated. A comparative analysis was done between those who received palliative resection (PR) and those who were not operated on (NR).

Results: The overall median survival of the study population was 10±1 months, and the 3- and 5-year survival rates (YSR) were 8.5% and 2.5%, respectively. The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively. For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001). In univariate analysis, T classification, N classification, tumor location, palliative resection, adjuvant treatment, chemotherapy, and radiation therapy were factors that showed survival difference between PR and NR. Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

Conclusions: Without evidence of systemic disease, palliative resection may provide some survival benefit in selected locally advanced unresectable EHCs and adjuvant treatment may further improve survival outcome.

No MeSH data available.


Related in: MedlinePlus

A summary of selection of patients eligible for analysis is depicted.
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Figure 1: A summary of selection of patients eligible for analysis is depicted.

Mentions: Between 1995 and 2007, a total of 905 patients were diagnosed as EHC at Seoul National University Hospital. To exclude patients with systemic diseases, 163 patients with evidence of metastasis either on radiologic or operative findings were excluded. Among the remaining 742 patients, 339 patients with R0 resections (45.7%) and 123 patients with R1 resection (16.6%) were also excluded. 280 patients who were identified as inoperable patients due to locally advanced state were included in the analysis. Among them, 39 patients (13.9%) received R2 resections and 241 patients (86.1%) received percutaneous or endoscopic biliary drainage without operation. The former were identified as the palliative resection (PR) group and the latter as the non-resection (NR) group. The patient selection process is described in Fig. 1. Thirty-nine R2 resections included 4 cases of right hemihepatectomy with hepaticojejunostomy, 4 cases of left hemihepatectomy with hepaticojejunostomy, and 31 cases of bile duct segmental resection with hepaticojejunostomy.


Clinical features and survival outcome of locally advanced extrahepatic cholangiocarcinoma.

Lee SJ, Kwon W, Kang MJ, Jang JY, Chang YR, Jung W, Kim SW - Korean J Hepatobiliary Pancreat Surg (2014)

A summary of selection of patients eligible for analysis is depicted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492336&req=5

Figure 1: A summary of selection of patients eligible for analysis is depicted.
Mentions: Between 1995 and 2007, a total of 905 patients were diagnosed as EHC at Seoul National University Hospital. To exclude patients with systemic diseases, 163 patients with evidence of metastasis either on radiologic or operative findings were excluded. Among the remaining 742 patients, 339 patients with R0 resections (45.7%) and 123 patients with R1 resection (16.6%) were also excluded. 280 patients who were identified as inoperable patients due to locally advanced state were included in the analysis. Among them, 39 patients (13.9%) received R2 resections and 241 patients (86.1%) received percutaneous or endoscopic biliary drainage without operation. The former were identified as the palliative resection (PR) group and the latter as the non-resection (NR) group. The patient selection process is described in Fig. 1. Thirty-nine R2 resections included 4 cases of right hemihepatectomy with hepaticojejunostomy, 4 cases of left hemihepatectomy with hepaticojejunostomy, and 31 cases of bile duct segmental resection with hepaticojejunostomy.

Bottom Line: The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively.For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001).Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Little is known about clinical features and survival outcome in locally advanced unresectable extrahepatic cholangiocarcinoma (EHC). The aim was to investigate the clinical features and the survival outcome in these patients, and to evaluate the role of palliative resections in locally advanced unresectable EHC.

Methods: Between 1995 and 2007, 280 patients with locally advanced unresectable EHC were identified. Clinical, pathologic, and survival data were investigated. A comparative analysis was done between those who received palliative resection (PR) and those who were not operated on (NR).

Results: The overall median survival of the study population was 10±1 months, and the 3- and 5-year survival rates (YSR) were 8.5% and 2.5%, respectively. The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively. For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001). In univariate analysis, T classification, N classification, tumor location, palliative resection, adjuvant treatment, chemotherapy, and radiation therapy were factors that showed survival difference between PR and NR. Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

Conclusions: Without evidence of systemic disease, palliative resection may provide some survival benefit in selected locally advanced unresectable EHCs and adjuvant treatment may further improve survival outcome.

No MeSH data available.


Related in: MedlinePlus