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Impact of postoperative irradiation after non‐curative resection of hilar biliary cancer
Author(s) -
Kobayashi Shogo,
Nagano Hiroaki,
Marubashi Shigeru,
Takeda Yutaka,
Tanemura Masahiro,
Konishi Koji,
Yoshioka Yasuo,
Inoue Takehiro,
Doki Yuichiro,
Mori Masaki
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21409
Subject(s) - medicine , surgical margin , margin (machine learning) , resection margin , radiation therapy , univariate analysis , cancer , lymph node , metastasis , retrospective cohort study , surgery , multivariate analysis , resection , machine learning , computer science
Background The aim of this retrospective study was to determine the effect of surgical margin on the outcome of postoperative radiotherapy (RT) in patients with resected hilar biliary cancer. Methods The study subjects were 87 patients with hilar biliary cancer resected surgically before 2008. Based on the Japanese Society of Biliary Surgery (JSBS) criteria for diagnosis of biliary cancer, the surgical margin status was categorized as margin 1 (histopathologically margin negative, but cancer cells identified within 5 mm from the margin), margin 2 (histopathologically margin positive), and margin 0 (other margin status). Results The surgical margin was 1 or 2 in 44 patients and 21 of these patients underwent RT. The 3‐year overall survival and progression‐free survival rates of the RT and non‐RT groups were 47% and 23% ( P = 0.0392), and 49% and 19% ( P = 0.0197), respectively. Univariate and multivariate analyses identified RT as the only factor that influenced survival. Subgroup analysis showed that the effect of RT was dependent on pathologically negative lymph node metastasis and positive margin (margin 2). Conclusion Postoperative RT is beneficial for patients with margins 1 and 2, especially those who are lymph node metastasis negative and have histopathologically positive margin. J. Surg. Oncol. 2009;100:657–662. © 2009 Wiley‐Liss, Inc.