Confinement to the intrapancreatic bile duct is independently associated with a better prognosis in extrahepatic cholangiocarcinoma

BMC Gastroenterology

Research Article

Yu Na Kang¹  Yong Hoon Kim²  Koo Jeong Kang²  Tae-Seok Kim²  Keun Soo Ahn² 

[1] Department of Pathology, Keimyung University School of Medicine, Dongsan Medical Center, 56 Dalsung-ro, Jung-gu, Daegu City, Republic of Korea;Department of Surgery, Keimyung University School of Medicine, Dongsan Medical Center, 56 Dalsung-ro, Jung-gu, Daegu City, Republic of Korea;

关键词: Extrahepatic cholangiocarcinoma;    Location;    Prognosis;   

DOI  :  10.1186/s12876-016-0444-1

 received in 2015-10-16, accepted in 2016-02-18,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundActual differences of long term outcome of extrahepatic cholangiocarcinoma according to the location of the tumor have not yet been studied. The aim of this study was to evaluate the prognosis and optimal surgical procedure for middle (BD) cancer.MethodsAmong 109 patients with carcinoma of the extrahepatic BD underwent surgical resection, curative resection of extrahepatic BD cancer was performed in 90 patients. They were classified into three groups according to the location of tumors: DISTAL (n = 32), tumor was confined to the intrapancreatic bile duct; MID (n = 20), tumor was located between below the confluence of the hepatic duct bifurcation and suprapancreatic portion of the BD; and DIFFUSE (n = 38), tumor was located diffusely.ResultsTumor involving the middle BD (MID or DIFFUSE) had a higher rate of perineural invasion as compared to the DISTAL group. The overall and disease-free survival rate for the MID or DIFFUSE group was significantly worse than that of DISTAL. In the MID/DIFFUSE group, there was no significant difference of survival according to the type of the operation (pancreaticoduodenectomy or segmental BD resection). The multivariate analysis showed that tumor involving middle BD (MID or DIFFUSE group) and node metastasis were independently poor prognostic factors for the disease free and overall survival.ConclusionExtrahepatic cholangiocarcinoma involving the extrapancreatic BD has a worse prognosis than those confined to the intrapancreatic BD. In patients with tumors confined to the middle BD, BD resection can be considered as an alternative surgical procedure to pancreaticoduodenectomy, if an R0 resection can be accomplished.

【 授权许可】

CC BY   
© Ahn et al. 2016