Indications for resection of recurrent lesions in patients with distal cholangiocarcinoma based on prognostic factors: a single-institute retrospective study and brief literature review

BMC Surgery

Research

Yoshihito Masuoka¹  Toshio Nakagohri¹  Shigenori Ei¹  Kazuo Koyanagi¹  Toshihito Ogasawara¹  Masaki Mori¹  Seiichiro Yamamoto¹  Shinichiro Takahashi¹  Taro Mashiko¹ 

[1] Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, 259-1193, Isehara, Kanagawa, Japan;

关键词: Distal cholangiocarcinoma;    Prognostic factors;    Surgery for recurrence;   

DOI  :  10.1186/s12893-022-01879-3

 received in 2022-07-08, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTo evaluate the effectiveness of surgery for recurrent distal cholangiocarcinoma and determine surgical indications based on prognostic factors for the recurrence of distal cholangiocarcinoma.MethodsWe analysed the outcomes of 101 patients who underwent surgical resection for distal cholangiocarcinoma between 2000 and 2018. The clinicopathological factors and prognosis of primary and recurrent distal cholangiocarcinoma were investigated.ResultsOf the 101 patients with resected distal cholangiocarcinoma, 52 (51.5%) had relapsed. Seven (13.5%) and 45 patients (86.5%) underwent resection of recurrent lesions and palliative therapy, respectively. There were no major complications requiring therapeutic intervention after metastasectomy. The median overall survival in patients with and without surgery for recurrent lesions was 83.0 (0.0–185.6) and 34 months (19.0–49.0), respectively. Therefore, patients who had undergone surgery for recurrent lesions had a significantly better prognosis (p = 0.022). Multivariate analyses of recurrent distal cholangiocarcinoma revealed that recurrence within one year was an independent predictor of poor survival. Resection of recurrent lesions improved prognosis.ConclusionsRadical resection in recurrent distal cholangiocarcinoma may improve the prognosis in selected patients. Although time to recurrence is considered an important factor, the small number of cases of recurrence and resection of recurrent lesions in this study makes it difficult to conclude which patients are best suited for resection of recurrent lesions. This issue requires clarification in a multicentre prospective study, considering patients’ background, such as the recurrence site and number of metastases.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 2

Fig. 4