Open AccessDisease recurrence patterns after R0 resection of hilar cholangiocarcinoma
Author(s) -
Kobayashi A.,
Miwa S.,
Nakata T.,
Miyagawa S.
Publication year - 2010
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.6788
Subject(s) - medicine , porta hepatis , surgery , stage (stratigraphy) , concomitant , hepatectomy , distant metastasis , bile duct cancer , metastasis , lymph node , retrospective cohort study , resection , cancer , bile duct , paleontology , biology
Background: There is little information regarding the clinical behaviour of hilar cholangiocarcinoma after curative resection. Methods: A retrospective study was undertaken of 79 consecutive patients with hilar cholangiocarcinoma who had undergone major hepatectomy (three or more Couinaud segments) concomitant with caudate lobectomy, and had negative resection margins. Sites of initial disease recurrence were classified as locoregional (porta hepatis) or distant (intrahepatic, peritoneal, para‐aortic lymph nodal or extra‐abdominal). Univariable and multivariable analyses were performed to determine the factors potentially related to recurrence. Results: Disease recurrence was observed in 42 (53 per cent) of the 79 patients. Cumulative recurrence rates at 3 and 4 years after surgery were 52 and 56 per cent respectively. Locoregional recurrence alone was observed in eight (10 per cent) and distant metastasis in 34 (43 per cent) of the 79 patients after R0 resection. Positive nodal involvement and high International Union Against Cancer tumour (T) stage were independent prognostic factors associated with distant metastasis. Conclusion: Distant metastases are more common than locoregional recurrence after R0 resection for hilar cholangiocarcinoma, and associated with nodal involvement and high T stage. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.