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- Title
Survival Benefits of Surgical Resection in Patients with Recurrent Biliary Tract Carcinoma.
- Authors
Motoyama, Hiroaki; Kobayashi, Akira; Yokoyama, Takahide; Shimizu, Akira; Kitagawa, Noriyuki; Notake, Tsuyoshi; Fukushima, Kentaro; Masuo, Hitoshi; Yoshizawa, Takahiro; Miyagawa, Shin-Ichi
- Abstract
Background: Whether surgical resection for recurrent biliary tract carcinoma (BTC) prolongs survival and the patients who are most likely to benefit from such treatment remain unclear. Methods: Among 251 patients with recurrences after the initial resection of BTC, a total of 21 patients (8.4%) underwent surgical resection for the recurrence, with a zero mortality rate. The clinicopathological features of these patients were compared with those of patients who did not undergo surgery. Results: The median survival time (MST) after the first recurrence and the 5-year post-recurrent survival (PRS) rate were 19.8 months and 32.8%, respectively, for patients who underwent re-resection. Fourteen patients (66.7%) experienced second recurrences; however, none of these patients underwent further surgical resection. Surgical resection for recurrence was identified as an independent prognostic factor for survival after recurrence (hazard ratio of 0.33, 95% CI of 0.17-0.58, p < 0.001). Patients with less than three liver metastases had a significantly better PRS after surgical resection than after chemotherapy ( p = 0.015). Among the patients with an isolated solitary liver metastasis, patients who underwent resection had a significantly longer MST after the first recurrence than patients receiving chemotherapy (22.8 vs. 10.9 months, p = 0.025), whereas the PRS was similar between the two groups among patients with two liver lesions. Conclusions: Surgical resection for recurrent BTC may prolong survival in highly selected patients. A hepatectomy might offer a survival benefit for patients with a solitary liver metastasis.
- Subjects
BILIARY tract cancer; CANCER patients; HEPATECTOMY; CANCER treatment; PHYSIOLOGICAL effects of chemotherapy
- Publication
World Journal of Surgery, 2017, Vol 41, Issue 11, p2817
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-017-4107-3