KAWAHARA RYUICHI, MIDORIKAWA RYUUTA, TANIWAKI SHINICHI, KOJIMA SATOKI, KANNO HIROKI, YOSHITOMI MUNEHIRO, NOMURA YORIKO, GOTO YUICHI, SATOU TOSHIHIRO, SAKAI HISAMUNE, ISHIKAWA HIROTO, HISAKA TORU, YASUNAGA MASAFUMI, SAKAUE TAKAHIKO, USHIJIMA TOMOYUKI, YASUMOTO MAKIKO, OKABE YOSHINOBU, TANIGAWA MASAHIKO, NAITOU YOSHIKI, YANO HIROHISA, OKUDA KOJI. Prognostic Factors for Distal Bile Duct Carcinoma After Surgery.
Kurume Med J 2023. [PMID:
37005293 DOI:
10.2739/kurumemedj.ms682002]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
BACKGROUND
Distal bile duct carcinoma continues to be one of the most difficult cancers to manage in terms of staging and radical resection. Pancreaticoduodenectomy (PD) with regional lymph node dissection has become the standard treatment of distal bile duct carcinoma. We evaluated treatment outcomes and histological factors in patients with distal bile duct carcinoma.
METHODS
Seventy-four cases of resection of carcinoma of the distal bile ducts treated at our department during the period from January 2002 and December 2016 using PD and regional lymph node dissection as the standard surgical procedure were investigated. Survival rates of factors were analyzed using uni- and multivariate analyses.
RESULTS
The median survival time was 47.8 months. On univariate analysis, age of 70 years or older, histologically pap, pPanc2,3, pN1, pEM0, v2,3, ly2,3, ne2,3 and postoperative adjuvant chemotherapy were statistically significant factors. On multivariate analysis, histologically pap was identified as a significant independent prognostic factor. The multivariate analysis identified age of 70 years or older, pEM0, ne2,3 and postoperative adjuvant chemotherapy as showing a significant trend towards independent prognostic relevance.
CONCLUSION
The good news about resected distal bile duct carcinoma is that the percentage of those who achieved R0 resection has risen to 89.1%. Our multivariate analysis identified age of 70 years or older, pEM0, ne2,3 and postoperative adjuvant chemotherapy as prognostic factors. In order to improve the outcome of treatment, it is necessary to improve preoperative diagnostic imaging of pancreatic invasion and lymph node metastasis, establish the optimal operation range and clarify whether aortic lymph node dissection is needed to control lymph node metastasis, and establish effective regimens of chemotherapy.
Collapse