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The true prognosis of resected distal cholangiocarcinoma
Author(s) -
CourtinTanguy Laetitia,
Rayar Michel,
Bergeat Damien,
Merdrignac Aude,
Harnoy Yann,
Boudjema Karim,
Meunier Bernard,
Sulpice Laurent
Publication year - 2016
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.24165
Subject(s) - medicine , propensity score matching , pancreaticoduodenectomy , pancreatic ductal adenocarcinoma , oncology , gastroenterology , pancreatic cancer , surgery , cancer , pancreas
Background Prognosis of distal cholangiocarcinoma (DCC) after pancreaticoduodenectomy (PD) remains poorly assessed. The aims of this study were to describe the oncological results of PD in DCC and to compare its prognosis to pancreatic ductal adenocarcinoma (PDAC). Methods All PD for periampullary carcinoma performed between January 2000 and March 2013 were extracted from a prospective database. Risk factors likely to influence overall (OS) and disease‐free (DFS) survivals of DCC were assessed by multivariable analyses. The DCC and PDAC prognoses were compared after matching using propensity score (nearest neighbor matching). Results Of the 290 patients analyzed, 56 had DCC, with a mean age of 65 ± 15 years. The median OS was 36.9 months. Recurrence occurred in 35 patients (67%), mostly in the liver (37%). The median DFS was 14.6 months. Combined organ resection was an independent risk factor for worse OS and DFS ( P = 0.01 and P = 0.001, respectively). Matching analysis found no significant difference between DCC and PDAC in terms of OS ( P = 0.284) or DFS ( P = 0.438). Conclusion This first propensity analysis demonstrated that DCC and PDAC have the same prognosis, linked to the high rate of early recurrence, particularly associated with the need for combined organ resection. J. Surg. Oncol. 2016;113:575–580 . © 2016 Wiley Periodicals, Inc.