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World Journal of Surgery
Published in: World Journal of Surgery 11/2017

01-11-2017 | Original Scientific Report

Survival Benefits of Surgical Resection in Patients with Recurrent Biliary Tract Carcinoma

Authors: Hiroaki Motoyama, Akira Kobayashi, Takahide Yokoyama, Akira Shimizu, Noriyuki Kitagawa, Tsuyoshi Notake, Kentaro Fukushima, Hitoshi Masuo, Takahiro Yoshizawa, Shin-ichi Miyagawa

Published in: World Journal of Surgery | Issue 11/2017

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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.
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Metadata
Title
Survival Benefits of Surgical Resection in Patients with Recurrent Biliary Tract Carcinoma
Authors
Hiroaki Motoyama
Akira Kobayashi
Takahide Yokoyama
Akira Shimizu
Noriyuki Kitagawa
Tsuyoshi Notake
Kentaro Fukushima
Hitoshi Masuo
Takahiro Yoshizawa
Shin-ichi Miyagawa
Publication date
01-11-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4107-3

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