Survival Benefit of Hepatopancreatoduodenectomy for Cholangiocarcinoma in Comparison to Hepatectomy or Pancreatoduodenectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-11

AUTHORS

Yuji Kaneoka, Akihiro Yamaguchi, Masatoshi Isogai, Takashi Kumada

ABSTRACT

BACKGROUND: Perihilar and distal cholangiocarcinoma remain difficult to treat, and long-term survival is poor. We conducted a retrospective study of patients with cholangiocarcinoma to examine whether hepatopancreatoduodenectomy, in comparison to standard surgeries, provides a survival benefit. METHODS: Subjects were 75 patients with perihilar or distal cholangiocarcinoma who, between April 1997 and May 2007, underwent hepatectomy with bile duct resection (Hx, n = 29), pancreatoduodenectomy (PD, n = 32), or hepatopancreatoduodenectomy (HPD, n = 14) at our hospital. We compared surgical outcomes and survival between groups and identified factors negatively influencing survival. RESULTS: Morbidity and in-hospital mortality did not differ significantly between groups (Hx group, 34% and 10%, respectively; PD group, 44% and 3%; and HPD, 57% and 0%). The overall median survival time was 39 months, and overall 5-year survival (including in-hospital mortality) was 42%. Respective group values were as follows: Hx, 24 months and 31%; PD, 51 months and 49%, and HPD, 63 months and 50%. Although the number of patients was small, survival in the HPD was not influenced by the type of invasion whether widespread intramural invasion (n = 8), superficial spread (n = 4), or hepatoduodenal ligament invasion (n = 2). Multivariate analysis (Cox proportional hazards model) showed only perineural invasion (p = .007) and decreased curability (R1/2 resection) (p = .017) to be independent risk factors influencing survival. CONCLUSIONS: In cases of perihilar or distal cholangiocarcinoma, aggressive surgery must be aimed at overcoming perineural invasion. Our findings indicate that HPD improves survival of patients undergoing surgery for widespread cholangiocarcinoma in comparison to standard surgeries. More... »

PAGES

2662-2670

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-010-0702-2

DOI

http://dx.doi.org/10.1007/s00268-010-0702-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1047079016

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20607255


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