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01-06-2017 | Original Scientific Report

Pulmonary Metastasis After Resection of Cholangiocarcinoma: Incidence, Resectability, and Survival

Authors: Mihoko Yamada, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino

Published in: World Journal of Surgery | Issue 6/2017

Abstract

Background

There are few reports on pulmonary metastasis from cholangiocarcinoma; therefore, its incidence, resectability, and survival are unclear.

Methods

Patients who underwent surgical resection for cholangiocarcinoma, including intrahepatic, perihilar, and distal cholangiocarcinoma were retrospectively reviewed, and this study focused on patients with pulmonary metastasis.

Results

Between January 2003 and December 2014, 681 patients underwent surgical resection for cholangiocarcinoma. Of these, 407 patients experienced disease recurrence, including 46 (11.3%) who developed pulmonary metastasis. Of these 46 patients, 9 underwent resection for pulmonary metastasis; no resection was performed in the remaining 37 patients. R0 resection was achieved in all patients, and no complications related to pulmonary metastasectomy were observed. The median time to recurrence was significantly longer in the 9 patients who underwent surgery than in the 37 patients without surgery (2.5 vs 1.0 years, p < 0.010). Survival after surgery for primary cancer and survival after recurrence were significantly better in the former group than in the latter group (after primary cancer: 66.7 vs 0% at 5 years, p < 0.001; after recurrence: 40.0 vs 8.7% at 3 years, p = 0.003). Multivariate analysis identified the time to recurrence and resection for pulmonary metastasis as independent prognostic factors for survival after recurrence.

Conclusion

Resection for pulmonary metastasis originating from cholangiocarcinoma can be safely performed and confers survival benefits for select patients, especially those with a longer time to recurrence after initial surgery.

Ebata T, Yokoyama Y, Igami T et al (2012) Hepatopancreatoduodenectomy for cholangiocarcinoma: a single-center review of 85 consecutive patients. Ann Surg 256:297–305CrossRefPubMed

Ebata T, Nagino M, Kamiya J et al (2003) Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases. Ann Surg 238:720–727CrossRefPubMedPubMedCentral

Hemming AW, Mekeel K, Khanna A et al (2011) Portal vein resection in management of hilar cholangiocarcinoma. J Am Coll Surg 212:604–613 (discussion 613-606) CrossRefPubMed

Nagino M, Nimura Y, Nishio H et al (2010) Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Ann Surg 252:115–123CrossRefPubMed

Takahashi Y, Ebata T, Yokoyama Y et al (2015) Surgery for recurrent biliary tract cancer: a single-center experience with 74 consecutive resections. Ann Surg 262:121–129CrossRefPubMed

Groot Koerkamp B, Wiggers JK, Allen PJ et al (2015) Recurrence rate and pattern of perihilar cholangiocarcinoma after curative intent resection. J Am Coll Surg 221:1041–1049CrossRefPubMedPubMedCentral

Park SW, Park YS, Chung JB et al (2004) Patterns and relevant factors of tumor recurrence for extrahepatic bile duct carcinoma after radical resection. Hepatogastroenterology 51:1612–1618PubMed

Choi SB, Han HJ, Park PJ et al (2015) Disease recurrence patterns and analysis of clinicopathological prognostic factors for recurrence after resection for distal bile duct cancer. Am Surg 81:289–296PubMed

Valle J, Wasan H, Palmer DH et al (2010) Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. New Engl J Med 362:1273–1281CrossRefPubMed

10.

Ghafoori AP, Nelson JW, Willett CG et al (2011) Radiotherapy in the treatment of patients with unresectable extrahepatic cholangiocarcinoma. Int J Radiat Oncol Biol Phys 81:654–659CrossRefPubMed

11.

Takamura A, Saito H, Kamada T et al (2003) Intraluminal low-dose-rate 192Ir brachytherapy combined with external beam radiotherapy and biliary stenting for unresectable extrahepatic bile duct carcinoma. Int J Radiat Oncol Biol Phys 57:1357–1365CrossRefPubMed

12.

Brunner TB, Schwab D, Meyer T et al (2004) Chemoradiation may prolong survival of patients with non-bulky unresectable extrahepatic biliary carcinoma. A retrospective analysis. Strahlenther Onkol 180:751–757CrossRefPubMed

13.

Nagino M, Ebata T, Yokoyama Y et al (2013) Evolution of surgical treatment for perihilar cholangiocarcinoma: a single-center 34-year review of 574 consecutive resections. Ann Surg 258:129–140CrossRefPubMed

14.

Nagino M, Nimura Y, Kamiya J et al (1998) Segmental liver resections for hilar cholangiocarcinoma. Hepatogastroenterology 45:7–13PubMed

15.

Igami T, Ebata T, Yokoyama Y et al (2011) Staging of peripheral-type intrahepatic cholangiocarcinoma: appraisal of the new TNM classification and its modifications. World J Surg 35:2501–2509CrossRefPubMed

16.

Kiriyama M, Ebata T, Aoba T et al (2015) Prognostic impact of lymph node metastasis in distal cholangiocarcinoma. Br J Surg 102:399–406CrossRefPubMed

17.

Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655CrossRefPubMed

18.

Oyama K, Kanzaki M, Isaka T et al (2013) Surgery for metastatic lung tumor from malignant tumor of liver, biliary duct and pancreas. Kyobu Geka 66:305–310PubMed

19.

Noji T, Tsuchikawa T, Mizota T et al (2015) Surgery for recurrent biliary carcinoma: results for 27 recurrent cases. World J Surg Oncol 13:82CrossRefPubMedPubMedCentral

20.

Song SC, Heo JS, Choi DW et al (2011) Survival benefits of surgical resection in recurrent cholangiocarcinoma. J Korean Surg Soc 81:187–194CrossRefPubMedPubMedCentral

21.

Mahmoud N, Bullard Dunn K (2010) Metastasectomy for stage IV colorectal cancer. Dis Colon Rectum 53:1080–1092CrossRefPubMed

22.

Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84:324–338CrossRefPubMed

23.

Kong JH, Lee J, Yi CA et al (2012) Lung metastases in metastatic gastric cancer: pattern of lung metastases and clinical outcome. Gastric Cancer 15:292–298CrossRefPubMed

24.

Yoshida M, Ohtsu A, Boku N et al (2004) Long-term survival and prognostic factors in patients with metastatic gastric cancers treated with chemotherapy in the Japan Clinical Oncology Group (JCOG) study. Jpn J Clin Oncol 34:654–659CrossRefPubMed

25.

Ohkuwa M, Ohtsu A, Boku N et al (2000) Long-term results for patients with unresectable gastric cancer who received chemotherapy in the Japan Clinical Oncology Group (JCOG) trials. Gastric Cancer 3:145–150CrossRefPubMed

26.

Inoue M, Ohta M, Iuchi K et al (2004) Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 78:238–244CrossRefPubMed

27.

Zabaleta J, Aguinagalde B, Fuentes MG et al (2011) Survival after lung metastasectomy for colorectal cancer: importance of previous liver metastasis as a prognostic factor. Eur J Surg Oncol 37:786–790CrossRefPubMed

28.

Zampino MG, Maisonneuve P, Ravenda PS et al (2014) Lung metastases from colorectal cancer: analysis of prognostic factors in a single institution study. Ann Thorac Surg 98:1238–1245CrossRefPubMed

29.

Warwick R, Page R (2007) Resection of pulmonary metastases from colorectal carcinoma. Eur J Surg Oncol 33(Suppl 2):S59–S63CrossRefPubMed

30.

Iizasa T, Suzuki M, Yoshida S et al (2006) Prediction of prognosis and surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg 82:254–260CrossRefPubMed

31.

Kemp CD, Kitano M, Kerkar S et al (2010) Pulmonary resection for metastatic gastric cancer. J Thorac Oncol 5:1796–1805CrossRefPubMed

32.

Shiono S, Sato T, Horio H et al (2013) Outcomes and prognostic factors of survival after pulmonary resection for metastatic gastric cancer. Eur J Cardiothorac Surg 43:e13–e16CrossRefPubMed

33.

Kawamura M, Nakajima J, Matsuguma H et al (2008) Surgical outcomes for pulmonary metastases from hepatocellular carcinoma. Eur J Cardiothorac Surg 34:196–199CrossRefPubMed

34.

Nakagawa T, Kamiyama T, Nakanishi K et al (2006) Pulmonary resection for metastases from hepatocellular carcinoma: factors influencing prognosis. J Thorac Cardiovasc Surg 131:1248–1254CrossRefPubMed

35.

Ohba T, Yano T, Yoshida T et al (2012) Results of a surgical resection of pulmonary metastasis from hepatocellular carcinoma: prognostic impact of the preoperative serum alpha-fetoprotein level. Surg Today 42:526–531CrossRefPubMed

36.

Mizuguchi S, Nishiyama N, Izumi N et al (2016) Clinical significance of multiple pulmonary metastasectomy for hepatocellular carcinoma. World J Surg 40:380–387CrossRefPubMed

37.

Kitano K, Murayama T, Sakamoto M et al (2012) Outcome and survival analysis of pulmonary metastasectomy for hepatocellular carcinoma. Eur J Cardiothorac Surg 41:376–382CrossRefPubMed

38.

Arnaoutakis GJ, Rangachari D, Laheru DA et al (2011) Pulmonary resection for isolated pancreatic adenocarcinoma metastasis: an analysis of outcomes and survival. J Gastrointest Surg 15:1611–1617CrossRefPubMedPubMedCentral

39.

Ferrone CR, Kattan MW, Tomlinson JS et al (2005) Validation of a postresection pancreatic adenocarcinoma nomogram for disease-specific survival. J Clin Oncol 23:7529–7535CrossRefPubMedPubMedCentral

40.

Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113:37–49CrossRefPubMed

41.

Corona-Cruz JF, Dominguez-Parra LM, Saavedra-Perez D et al (2012) Lung metastasectomy: long-term outcomes in an 18-year cohort from a single center. Surg Oncol 21:237–244CrossRefPubMed

42.

Casiraghi M, De Pas T, Maisonneuve P et al (2011) A 10-year single-center experience on 708 lung metastasectomies: the evidence of the “international registry of lung metastases”. J Thorac Oncol 6:1373–1378CrossRefPubMed

Title: Pulmonary Metastasis After Resection of Cholangiocarcinoma: Incidence, Resectability, and Survival
Authors: Mihoko Yamada
Tomoki Ebata
Yukihiro Yokoyama
Tsuyoshi Igami
Gen Sugawara
Takashi Mizuno
Junpei Yamaguchi
Masato Nagino
Publication date: 01-06-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 6/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-3877-y

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Springer Medicine

Pulmonary Metastasis After Resection of Cholangiocarcinoma: Incidence, Resectability, and Survival

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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